Contemporary Perioperative Morbidity and Mortality Rates of Minimally Invasive vs Open Partial Nephrectomy in Obese Patients with Kidney Cancer

2019 ◽  
Vol 33 (11) ◽  
pp. 920-927
Author(s):  
Mahmoud I. Khalil ◽  
Joel Ubeda ◽  
Thomas Soehner ◽  
Naleen Raj Bhandari ◽  
Nalin Payakachat ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Partial Nephrectomy ◽  
Kidney Cancer ◽  
Mortality Rates ◽  
Morbidity And Mortality ◽  
Obese Patients ◽  
Open Partial Nephrectomy ◽  
Perioperative Morbidity

Long-term renal outcomes in obese patients after minimally invasive vs. open partial nephrectomy for the treatment of renal cancer – A retrospective study (Preprint)

2020 ◽  
Author(s):  
Brittany Roses ◽  
Bradley Jarrett Stone ◽  
SHELBIE Stahr ◽  
Mahmoud Khalil ◽  
Rodney Davis ◽  
...  
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Partial Nephrectomy ◽  
Invasive Surgery ◽  
Robotic Partial Nephrectomy ◽  
Obese Patients ◽  
Open Partial Nephrectomy ◽  
Renal Outcomes ◽  
Post Surgery

BACKGROUND Obesity has a significant association with renal cell carcinoma (RCC). Surgery is the preferred treatment of demarcated RCC. Obesity increases the complexity of surgical outcomes. There is a paucity of data regarding surgical technique outcomes in obese patients. OBJECTIVE We investigated short- and long-term renal outcomes in obese patients post-RCC surgery through open, laparoscopic, or robotic partial nephrectomy. METHODS This is a retrospective chart review of obese patients after open, laparoscopic, or robotic partial-nephrectomies over 12 years at a single center. The obese (BMI ≥ 30) and the non-obese (BMI< 30) patients were studied in 2-time frames: short (3-6 months post-surgery), or long (> 6 months) and followed up to 4 years. RESULTS Of the 140 patients, 75 were obese and 65 were non-obese. In the obese, 3-6 months after minimally-invasive surgery, the odds of having a decrease or no change in creatinine values were 0.62 times lower compared to open surgery. Over 6 months after minimally-invasive surgery, the odds were 1.24 times higher. Neither of these results were statistically significant. In the non-obese group, at 3-6 months after minimally-invasive surgery, the same odds were 4.86 times higher. This was statistically significant (P<0.05). Over 6 months after minimally invasive surgery, the odds were 4.13 times higher. This was not statistically significant. CONCLUSIONS We observed non-statistically significant preservation of renal function in obese patients undergoing OPN at 3-6 months postoperatively. Conversely, after 6 months, the same was true for MIPN, indicating a long-term benefit of MIPN. In the non-obese, MIPN was favored over OPN. CLINICALTRIAL na

scholarly journals Partial Nephrectomy A Comparison between Different Modalities

2021 ◽  
Vol 8 (2) ◽  
pp. 34-39
Author(s):  
Ahmed Al Asker ◽  
Abdulmalik Addar ◽  
Mohammed Alghamdi ◽  
Saud Alawad ◽  
Mohammed Alharbi ◽  
...  
Keyword(s):  
Blood Loss ◽  
Minimally Invasive ◽  
Hospital Stay ◽  
Partial Nephrectomy ◽  
Kidney Cancer ◽  
Tumor Size ◽  
Robotic Partial Nephrectomy ◽  
Chi Square ◽  
Open Partial Nephrectomy ◽  
Institutional Review

Kidney cancer, with 4% of all malignancies, is one of the most common malignancies occurring among in adults. In Saudi Arabia, kidney cancer comprises 2.3% of all cancers, and its incidence has increased by 33%. Partial nephrectomy (PN) is considered as the gold standard for T1 renal masses.In this retrospective study, we did a chart review for all patients who underwent PNs between April 2013 and February 2019. Data comprised pre-sentation, tumor size, type of procedure (open vs. laparoscopic vs. robotic), and intra- and post-operative complications. Chi-square, ANOVA, and cross-tabulation were done using SPSS software. P > 0.05 was considered significant. Approval was obtained from the institutional review board of King Abdullah International Medical Research Center.In all, 69 patients were identified: 26 (37.7%) males and 43 (62.3%) females, with mean age = 54.53 ± 13.21 years; mean body mass index = 32.36 ± 7.03, and mean tumor size = 3.7 ± 1.72 cm. In terms of presentation, most patients (50, 72.4%) presented incidentally as opposed to symptomatic presentation. Of these patients, 18 (26.1%) underwent open partial nephrectomy (OPN), 29 (42%) laparoscopic partial nephrec-tomy (LPN), and 22 (31.9%) robotic partial nephrectomy (RPN). On comparing minimally invasive surgery (MIS) PN with OPN, we found that OPN had more blood loss and a longer hospital stay but a shorter operating room (OR) time.Results of PN irrespective of the procedure type, whether it was OPN, LPN, or RPN, were similar if performed by experienced surgeons. However, open procedures involved a higher blood loss, more operative time, and longer hospital stay when compared with minimally invasive techniques.

Contemporary rates and predictors of open conversion during minimally invasive partial nephrectomy for kidney cancer

2021 ◽  
Vol 36 ◽  
pp. 131-137
Author(s):  
Stefano Luzzago ◽  
Giuseppe Rosiello ◽  
Angela Pecoraro ◽  
Marina Deuker ◽  
Franziska Stolzenbach ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Partial Nephrectomy ◽  
Kidney Cancer ◽  
Open Conversion

scholarly journals Cryoablation for Small Renal Masses

2008 ◽  
Vol 2008 ◽  
pp. 1-10 ◽  
Author(s):  
J. L. Dominguez-Escrig ◽  
K. Sahadevan ◽  
P. Johnson
Keyword(s):  
Minimally Invasive ◽  
Partial Nephrectomy ◽  
Imaging Techniques ◽  
Rapid Development ◽  
High Intensity Focused Ultrasound ◽  
Small Renal Masses ◽  
Renal Masses ◽  
Invasive Approach ◽  
Open Partial Nephrectomy ◽  
Ablative Techniques

Advances in imaging techniques (CT and MRI) and widespread use of imaging especially ultrasound scanning have resulted in a dramatic increase in the detection of small renal masses. While open partial nephrectomy is still the reference standard for the management of these small renal masses, its associated morbidity has encouraged clinicians to exploit the advancements in minimally invasive ablative techniques. The last decade has seen the rapid development of laparoscopic partial nephrectomy and novel ablative techniques such as, radiofrequency ablation (RFA), high-intensity focused ultrasound (HIFU), and cryoablation (CA). In particular, CA for small renal masses has gained popularity as it combines nephron-sparing surgery with a minimally invasive approach. Studies with up to 5-year followup have shown an overall and cancer-specific 5-year survival of 82% and 100%, respectively. This manuscript will focus on the principles and clinical applications of cryoablation of small renal masses, with detailed review of relevant literature.

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