scholarly journals Open Partial Nephrectomy for Pediatric Renovascular Hypertension

2009 ◽  
Vol 9 ◽  
pp. 287-290 ◽  
Author(s):  
Matt S. Ashley ◽  
Gregory Moneta ◽  
Siamak Daneshmand
Keyword(s):  
Renal Function ◽  
Partial Nephrectomy ◽  
Renovascular Hypertension ◽  
Radical Nephrectomy ◽  
Antihypertensive Medication ◽  
Alternative Therapy ◽  
Lower Pole ◽  
Renal Veins ◽  
Open Partial Nephrectomy ◽  
Arterial Bypass

Pediatric renovascular hypertension is typically managed with revascularization, angioplasty, or radical nephrectomy. We describe the case of a 13-year-old boy with medically refractory renovascular hypertension who presented to our institution after a failed arterial bypass. Subsequent angiography and renin sampling of the segmental renal veins suggested that the lower pole of the kidney was affected exclusively by the relative hypoperfusion. We proceeded with an open partial nephrectomy in order to excise the affected region of the kidney, while preserving maximum renal function. The patient was normotensive off all antihypertensive medication and without complications 8 months postoperatively. We believe that partial nephrectomy is a reasonable treatment for children with renovascular hypertension secondary to segmental hypoperfusion, and it should be considered as alternative therapy.

scholarly journals Open Partial Nephrectomy in Renal Cancer: A Feasible Gold Standard Technique in All Hospitals

2008 ◽  
Vol 2008 ◽  
pp. 1-9 ◽  
Author(s):  
J. M. Cozar ◽  
M. Tallada
Keyword(s):  
Partial Nephrectomy ◽  
Gold Standard ◽  
Radical Nephrectomy ◽  
Young Patients ◽  
Standard Technique ◽  
Tumor Diameter ◽  
Cancer Specific Survival ◽  
Renal Masses ◽  
Open Partial Nephrectomy ◽  
Gold Standard Technique

Introduction. Partial nephrectomy (PN) is playing an increasingly important role in localized renal cell carcinoma (RCC) as a true alternative to radical nephrectomy. With the greater experience and expertise of surgical teams, it has become an alternative to radical nephrectomy in young patients when the tumor diameter is 4 cm or less in almost all hospitals since cancer-specific survival outcomes are similar to those obtained with radical nephrectomy.Materials and Methods. The authors comment on their own experience and review the literature, reporting current indications and outcomes including complications. The surgical technique of open partial nephrectomy is outlined.Conclusions. Nowadays, open PN is the gold standard technique to treat small renal masses, and all nonablative techniques must pass the test of time to be compared to PN. It is not ethical for patients to undergo radical surgery just because the urologists involved do not have adequate experience with PN. Patients should be involved in the final treatment decision and, when appropriate, referred to specialized centers with experience in open or laparoscopic partial nephrectomies.

scholarly journals Polyethylene glycol-coated collagen patch (hemopatch®) in open partial nephrectomy

2021 ◽  
Author(s):  
Michael Staehler ◽  
S. Rodler ◽  
M. Schott ◽  
J. Casuscelli ◽  
C. Stief ◽  
...  
Keyword(s):  
Renal Function ◽  
Polyethylene Glycol ◽  
Blood Loss ◽  
Partial Nephrectomy ◽  
Low Complexity ◽  
High Complexity ◽  
Open Partial Nephrectomy ◽  
Duration Of Surgery ◽  
Coated Collagen

Abstract Purpose To describe the results of a polyethylene glycol-coated collagen patch, Hemopatch® on blood loss, surgical time and renal function in partial nephrectomy (PN) for renal cell carcinoma (RCC). Methods Out of a single surgeon cohort of n = 565 patients undergoing conventional open PN (CPN) between 01/2015 and 12/2017 at the University of Munich a consecutive subgroup (n = 42) was operated on using a polyethylene glycol-coated collagen-based sealant Hemopatch® (Baxter International Inc., Deerfield, IL, USA) (HPN). Results Median age was 65.2 years (range 12.7–95.2) with median follow-up of 9.43 months (0.03–49.15). Baseline renal function (CKD-EPI) was 78.56 ml/min/1.73 m2 (range 20.38–143.09) with a non-significant decline to 74.78 ml/min/1.73 m2 (range 3.75–167.74) at follow-up. In CPN 46% had low complexity, 33% moderate complexity and 20% high complexity lesions with 33% low, 40% moderate and 27% high complexity masses in HPN. Median tumor size was 4.3 cm (range 1–38 cm) in CPN with 4.8 cm (range 3.8–18.3 cm) with HPN, p = 0.293. Median blood loss and duration of surgery was significantly lower in the HPN group vs. CPN (146 ml ± 195 vs. 114 ml ± 159 ml; p = 0.021; 43 min ± 27 for HPN vs. 53 min ± 49; p = 0.035) with no difference in clamping time (12.6 min ± 8.6 for HPN vs. 12.0 min ± 9.5; p = 0.701). Conclusions Hemopatch® supported renoraphy shows promising results compared to standard renoraphy in PN. No side effects were seen. Further studies should evaluate the prevention of arterio-venous or urinary fistulas. In complex partial nephrectomies Hemopatch® supported renoraphy should be considered.

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