Perioperative and Long-Term Outcomes of Robot-Assisted Partial Nephrectomy: A Systematic Review

2020 ◽  
pp. 000313482094891
Author(s):  
Amber B. Tang ◽  
Margherita Lamaina ◽  
Christopher P. Childers ◽  
Selene S. Mak ◽  
Qiao Ruan ◽  
...  
Keyword(s):  
Blood Loss ◽  
Partial Nephrectomy ◽  
Oncologic Outcomes ◽  
Surgical Approaches ◽  
Long Term Outcomes ◽  
Robot Assisted ◽  
Cancer Specific Survival ◽  
Open Partial Nephrectomy ◽  
Estimated Blood Loss

Background Adoption of the robotic surgical platform for small renal cancers has rapidly expanded, but its utility compared to other approaches has not been established. The objective of this review is to assess perioperative and long-term oncologic and functional outcomes of robot-assisted partial nephrectomy (RAPN) compared to laparoscopic partial nephrectomy (LPN) and open partial nephrectomy (OPN). Methods A search in PubMed, Embase, and Cochrane (2010-2019) was conducted. Of 3877 articles screened, 7 observational studies were included. Results RAPN was associated with 24-50 mL less intraoperative blood loss compared to LPN and 39-84 mL less than OPN. RAPN also demonstrated trends of other postoperative benefits, such as shorter length of stay and fewer major complications. Several studies reported better long-term functional kidney outcomes, but these findings were inconsistent. Recurrence and cancer-specific survival (CSS) were similar across groups. While RAPN had a 5-year CSS of 90.1%-97.9%, LPN and OPN had survival rates of 85.9%-86.9% and 88.5-96.3% respectively. Conclusions RAPN may be associated with a lower estimated blood loss and comparable long-term outcomes when compared to other surgical approaches. However, additional randomized or propensity matched studies are warranted to fully assess long-term functional kidney and oncologic outcomes.

scholarly journals Use of a novel parenchymal clamp for laparoscopic and open partial nephrectomy

2013 ◽  
Vol 4 (5) ◽  
pp. 133 ◽  
Author(s):  
Paul Toren ◽  
Turki Al-Essawi ◽  
Anthony Mclean ◽  
Umesh Jain
Keyword(s):  
Blood Loss ◽  
Partial Nephrectomy ◽  
Laparoscopic Partial Nephrectomy ◽  
Oncologic Outcomes ◽  
Open Partial Nephrectomy ◽  
Estimated Blood Loss ◽  
Hilar Dissection ◽  
Excellent Preservation ◽  
Initial Results

Increasing data advocates the wider use of partial nephrectomy forrenal tumours amenable to this approach. We describe the initialNorth American use of a novel parenchymal clamp in an openand a laparoscopic partial nephrectomy. Initial results in 3 patients(2 open, 1 laparoscopic) demonstrate excellent preservation ofrenal function and good oncologic outcomes. Hilar dissection wasavoided in all cases and the estimated blood loss was low. In oursmall series, we found this device to be a safe and useful adjunctto partial nephrectomy.

scholarly journals Combined assessment of long-term functional and oncologic outcomes after robot-assisted partial nephrectomy: The ROMe’s score

2020 ◽  
Vol 19 ◽  
pp. e225-e226
Author(s):  
A. Brassetti ◽  
U. Anceschi ◽  
R. Bertolo ◽  
S. Guaglianone ◽  
M. Ferriero ◽  
...  
Keyword(s):  
Partial Nephrectomy ◽  
Oncologic Outcomes ◽  
Robot Assisted

Robot‐assisted partial nephrectomy for high‐complexity tumors (PADUA score ≥10): Perioperative, long‐term functional and oncologic outcomes

2021 ◽  
Author(s):  
Periklis Koukourikis ◽  
Ali Abdullah Alqahtani ◽  
Ahmad Almujalhem ◽  
Jongsoo Lee ◽  
Woong Kyu Han ◽  
...  
Keyword(s):  
Partial Nephrectomy ◽  
Oncologic Outcomes ◽  
High Complexity ◽  
Robot Assisted

scholarly journals Association between R.E.N.A.L nephrometry score and perioperative outcomes following open partial nephrectomy under cold ischemia

2014 ◽  
Vol 8 (3-4) ◽  
pp. 137
Author(s):  
Dong Soo Park ◽  
Jin Ho Hwang ◽  
Moon Hyung Kang ◽  
Jong Jin Oh
Keyword(s):  
Blood Loss ◽  
Partial Nephrectomy ◽  
Perioperative Outcomes ◽  
Renal Neoplasm ◽  
Cold Ischemia ◽  
Ischemic Time ◽  
Open Partial Nephrectomy ◽  
Cold Ischemic Time ◽  
Nephrometry Score ◽  
Estimated Blood Loss

Introduction: We investigate the clinical significance of the R.E.N.A.L. nephrometry score for renal neoplasm following open partial nephrectomy (PN) under cold ischemia.Methods: A retrospective analysis was conducted using clinical data of 98 consecutive patients with clear cell renal cell carcinoma who underwent open PN by a single surgeon from December 2000 to September 2012. Tumour complexity was stratified into 3 categories: low (4-6), moderate (7-9) and high (10-12) complexity. Perioperative outcomes, such as complications, cold ischemic time, estimated blood loss and renal function, were analyzed according to the complexity by NS. Complications were stratified using the Clavien-Dindo classification system.Results: Tumour complexity according to nephrometry score was assessed as low in 16 (16.3%), moderate in 48 (49.0%) and high in 34 (34.7%). The median cold ischemic time did not differ significantly among the 3 groups (36.0 minutes in low-, 40 minutes in moderate- and 43 minutes in the high-complexity group, p = 0.421). Total complications did not differ significantly (2 (2.0%) in low, 4 (4.1%) in moderate and 4 (4.1%) in high, p = 0.984). Each Grade 3 complication occurred in the moderate (urine leakage) and high groups (lymphocele). Postoperative renal functional outcomes were similar among the groups (p = 0.729). Only mean estimated blood loss was significantly different with nephrometry score (p = 0.049).Conclusions: The nephrometry score, as used in an open PN series under cold ischemia, was not significantly associated with perioperative outcomes (i.e., ischemia time, complications, renal functional preservation).

scholarly journals MP57-09 COMBINED ASSESSMENT OF LONG-TERM FUNCTIONAL AND ONCOLOGIC OUTCOMES AFTER ROBOT-ASSISTED PARTIAL NEPHRECTOMY

2020 ◽  
Vol 203 ◽  
pp. e862-e863
Author(s):  
Aldo Brassetti* ◽  
Umberto Anceschi ◽  
Riccardo Bertolo ◽  
Salvatore Guaglianone ◽  
Mariaconsiglia Ferriero ◽  
...  
Keyword(s):  
Partial Nephrectomy ◽  
Oncologic Outcomes ◽  
Robot Assisted

Clinical outcome of Laparoscopic and Robot-assisted Radical Cystectomy for Bladder Cancer in a Retrospective Study

2021 ◽  
Author(s):  
YuChen Bai ◽  
Shuai Wang ◽  
Wei Zheng ◽  
Jing Quan ◽  
Fei Wei ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Retrospective Study ◽  
Postoperative Complications ◽  
Blood Loss ◽  
Radical Cystectomy ◽  
Perioperative Outcomes ◽  
Robot Assisted ◽  
Long Term Outcome ◽  
Estimated Blood Loss

Abstract Background: With the rapid development of surgical technics and instruments, more and more bladder cancer patients are being treated by laparoscopic radical cystectomy (LRC) and robot-assisted radical cystectomy (RARC) .The aim of this retrospective study was to compare the perioperative and long-term outcomes of patients who underwent cystectomy by these two surgical approaches. Methods: We performed a retrospective review of the prospectively collected database of our hospital to identify patients with clinical stage Ta/T1/Tis to T3 who underwent RARC and LRC. Perioperative outcomes, recurrence, and overall survival (OS) were analyzed. Results: From March 2010 to December 2019, there were total of 218 patients, which including 82(38%) patients with LRC and 136(62%) patients with RARC. No perioperative death was observed in both groups. Tumor recurrence, death from any causes, and cancer-specific death occurred in 77, 55, and 39 patients respectively. The 5-year DFS, OS, and CSS rates for all included patients were 55.4%, 62.4%, and 66.4%, respectively. There were no significantly statistically differences between the RARC group and the LRC group for number of lymph nodes harvested, positive lymph node rate, positive margin rate and postoperative pathological stage (all P>0.05). Patients undergoing RARC had lower median estimated blood loss (180mL vs. 250 mL; P 0.015) and 90-days postoperative complications (30.8% vs. 46.3%; P 0.013) than LRC.Conclusions: For selected patients with RARC and LRC, both were safe and effective with a low complication rate and similar long-term outcome compared two groups. Moreover, the robotic approach resulted in lower median estimated blood loss and better outcome in postoperative complications.

scholarly journals Open Partial Nephrectomy with Zero Ischaemia Using a Supra 12th Rib Miniflank Incision: A Minimally Invasive Open Approach for Small Renal Masses

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Syed Ali Ehsanullah ◽  
Abida Sultana ◽  
Brian Kelly ◽  
Charlotte Dunford ◽  
Zaheer Shah
Keyword(s):  
Renal Function ◽  
Blood Loss ◽  
Minimally Invasive ◽  
Partial Nephrectomy ◽  
Operative Time ◽  
Tumour Size ◽  
Open Approach ◽  
Open Partial Nephrectomy ◽  
Estimated Blood Loss ◽  
The Mean

Introduction. To assess a minimally invasive open technique for partial nephrectomy with zero ischaemia time. Methods. A review was performed in a prospectively maintained database of a single surgeon series of all patients undergoing partial nephrectomy using a supra 12th rib miniflank incision with zero ischaemia. Data of seventy one patients who underwent a partial nephrectomy over an 82-month period were analyzed. Data analyzed included operative time, estimated blood loss, pre and postoperative renal function, complications, final pathological characteristics, and tumour size. Results. Seventy one partial nephrectomies were performed from February 2009 to October 2015. None were converted to radical nephrectomy. Mean operative time was 72 minutes (range 30–250), and mean estimated blood loss was 608 mls (range 100–2500) with one patient receiving blood transfusion. The mean pre and postoperative haemoglobin levels were 144 and 112 g/l. The mean pre and postoperative creatinine levels were 82 and 103 Umol/L. There were 8 Clavian–Dindo Grade 2 complications and 1 major complication (Clavian IIIa). Histology confirmed 24 benign lesions and 47 malignant lesions, 46 cT1a lesions, 24 cT1b lesions, and 1 cT2 lesion. Median follow-up was 38 months with no local recurrence or progression of disease with 5 patients having a positive margin (7%). Conclusion. Our results demonstrate that a supra 12th miniflank incision open partial nephrectomy with zero ischaemic time for SRMs has satisfactory outcomes with preservation of renal function. A minimally invasive open partial nephrectomy remains an important option for units that cannot offer patients a laparoscopic or a robotic procedure.

Comparison of Laparoscopic and Open Partial Nephrectomy in the Treatment of T1 Renal Tumor:a Systematic Review and Meta-analysis

2020 ◽  
Author(s):  
Yuanming Sui ◽  
Zongliang Zhang ◽  
Huaqing Sun ◽  
Kai Zhao ◽  
Zhenlin Wang ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Partial Nephrectomy ◽  
Meta Analysis ◽  
Positive Margin ◽  
Current Evidence ◽  
Surgical Approaches ◽  
Open Partial Nephrectomy ◽  
Ischemia Time ◽  
Standard Mean Difference ◽  
Estimated Blood Loss

Abstract Objective:Different surgical approaches may bring different treatment results for one disease.We thus determined to gather the current evidence to evaluate the effect of laparoscopic partial nephrecomy(LPN) and open partial nephrectomy(OPN) in the treatment of T1 renal tumor.Methods:We comprehensively researched PubMed,Embase,Google Scholar and Clinicaltrials.gov to find all referring studies(published between Jan1,2015,and Jan 1,2020 without language restrictions) .We calculated the odds ratios(OR) and standard mean difference(SMD),and analyzed their heterogeneity with RevMan 5.3 software.Results:Six studies were included finally.Comparing open partial nephrectomy, the pooled SMD of operative time was 0.14, (95% confidential index CI = [-0.11, 0.38]), the pooled SMD of estimated blood loss was -0.14, (95% CI = [-0.58, 0.31]), the pooled SMD of ischemia time was 0.57, (95% CI = [-0.02, 1.16]), the pooled SMD of length of stay was -0.55, (95% CI = [-1.12, 0.02]),and the pooled OR of positive margin was 1.02, (95% CI = [0.39, 2.68]),the pooled OR of postoperative complications was 0.74,(95% CI = [0.41, 1.36]). Conclusions:LRN had advantages on decreasing postoperative complications rate but the ischemia time of OPN was much shorter.

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