scholarly journals Preoperative scoring systems used in retroperitoneoscopic partial nephrectomy for T1-T2 renal tumors

2017 ◽  
Vol 12 (3) ◽  
pp. 141-147
Author(s):  
M.V. PIRVUT ◽  
◽  
N. GRIGORE ◽  
I. MIHAI ◽  
A. BENCHERKI ◽  
...  
Keyword(s):  
Blood Loss ◽  
Partial Nephrectomy ◽  
Operative Time ◽  
Warm Ischemia ◽  
Warm Ischemia Time ◽  
P Value ◽  
Ischemia Time ◽  
Contralateral Kidney ◽  
Risk Patients ◽  
The Mean

Introduction. P.A.D.U.A. (The preoperative aspects and dimensions used for anatomic), R.E.N.A.L. (radius exophytic/endophytic nearness anterior/posterior location) and zonal NePhRO scoring were developed in an effort to predict the intraoperative (warm time ischemia, blood loss) and postoperative complications in patients undergoing partial nephrectomy, with an important role on surgical decision-making (2-4). Materials and methods. Between January 2014 and July 2017, 37 patients(p) underwent retroperitoneoscopic nephro-sparing surgery at our center for clinically localized renal tumor. All patients had a normal contralateral kidney. The selection of patients for nephro-sparing surgery was based on preoperative CT scan, location of the tumor, the individual general health status of the patient and individual surgeon preferences. A chart review was carried out, including age, sex, anatomic preoperative scoring system (P.A.D.U.A., R.E.N.A.L. nephrometry and zonal NePhRO), operative time (skin opening to skin closing), estimated blood loss (EBL), warm ischemia time (WIT), hospital stay. Results. The mean age of patients with partial nephrectomy was 54.3±9.1 years. Mean preoperative serum creatinine level for the patient group was 0.97±0.14 mg/dl. All patients had normal contralateral kidney. Average tumor diameter in this group was 3.6± 0.86 cm. When using P.A.D.U.A. score to predict warm time ischemia p value was of 0.001, even if the mean warm ischemia time is higher in medium risk patients than in high risk patients 24.3 min vs. 23.2 min. R.E.N.A.L. nephrometry score was able to predict the warm ischemia time according to the risk groups (17.6 vs. 23.9 vs. 31 min) with a p value under 0.001. Zonal NePhRO score was statistically correlated with total operative time, blood loss, warm ischemia and renal function decrease, all with a p value < 0.05. Conclusion. P.A.D.U.A. score, R.E.N.A.L. nephrometry score and Zonal NePhRO score have proved to be reliable preoperative tools in order to evaluate surgical complexity and to predict outcomes such as warm time ischemia, blood loss, postoperative estimated GFR and complications rate.

scholarly journals Predictors of surgical outcomes of retroperitoneal laparoscopic partial nephrectomy

2020 ◽  
Vol 92 (3) ◽  
Author(s):  
Carmine Sciorio ◽  
Pier Paolo Prontera ◽  
Salvatore Scuzzarella ◽  
Paolo Verze ◽  
Lorenzo Spirito ◽  
...  
Keyword(s):  
Blood Loss ◽  
Partial Nephrectomy ◽  
Surgical Outcomes ◽  
Operative Time ◽  
Statistical Significance ◽  
Tumour Size ◽  
Warm Ischemia ◽  
Warm Ischemia Time ◽  
Ischemia Time ◽  
Length Of Hospitalization

Objectives: To evaluate surgical outcomes in a series of laparoscopic retroperitoneal partial nephrectomies.Methods: A total of 147 patients who underwent laparoscopic retroperitoneal partial nephrectomy by a single surgeon were evaluated. Pre-operative parameters (body mass index, ASA score, tumour size, cTNM stage, PADUA score risk, surgeon experience) and intraoperative and postoperative outcomes (operative mean time, warm ischemia time, blood loss, transfusion rate, length of hospitalization, and margin-ischaemiacomplications [MIC] success rate) were considered. Results: For 134 patients (91.1%) the success of the treatment, defined by a MIC = 3, was obtained. When the statistical significance of each of the independent variables was tested, surgeon’s experience added statistical significance to the prediction of operative time (p = 0.000), warm ischemia time (p = 0.000) and blood loss (p = 0.000); tumour size (p = 0.046) to the prediction MIC (p = 0.010), operative time (p = 0.000), warm ischemia time (p = 0.003) and blood loss (p = 0.010); ASA score to the length of hospitalization (p = 0.009). Conclusions: Laparoscopic retroperitoneal partial nephrectomy represents an adequate and safe technique for the treatment of T1 renal cancer. Optimal MIC success rate can be achieved, although intraoperative outcomes tend to be related to the learning curve even in a very experienced laparoscopic surgeon. Length of hospitalization depends on general health condition of patients.

scholarly journals Knotless retroperitoneoscopic nephron-sparing surgery for small renal masses: Comparison of bipolar sutureless technique and barbed suture technique

2018 ◽  
Vol 46 (4) ◽  
pp. 1649-1656 ◽  
Author(s):  
Jianfei Ye ◽  
Shudong Zhang ◽  
Xiaojun Tian ◽  
Guoliang Wang ◽  
Lei Zhao ◽  
...  
Keyword(s):  
Operative Time ◽  
Suture Technique ◽  
Warm Ischemia ◽  
Warm Ischemia Time ◽  
Nephron Sparing Surgery ◽  
Barbed Suture ◽  
Ischemia Time ◽  
Sutureless Technique ◽  
Nephron Sparing ◽  
The Mean

Objective Laparoscopic knot-tying and suturing are the most difficult steps in shortening the warm ischemia time and learning curve of laparoscopic nephron-sparing surgery. This study was performed to demonstrate the safety, oncological efficacy, and technical tips of sutureless retroperitoneal laparoscopic nephron-sparing surgery (RPNSS). Methods This retrospective study included 78 cases of RPNSS using a sutureless technique and 126 cases of RPNSS using a single-layer barbed self-retaining suture technique performed from December 2012 to December 2016. Results The mean warm ischemia time was significantly shorter in the sutureless technique group than in the barbed self-retaining suture technique group (6.8 vs. 21.1 minutes, respectively). There was no significant difference in the mean age, body mass index, R.E.N.A.L. Nephrometry score, operative time, maximal tumor diameter, intraparenchymal depth, blood loss, operative time, transfusion rate, complication rate, or postoperative hospital stay between the two groups. No open conversion was needed. No positive margins or local recurrence were observed during follow-up. Conclusions The sutureless technique was proven to be safe and oncologically effective and may allow novice laparoscopic surgeons to easily and quickly master RPNSS, a technically difficult procedure.

V218: Eliminating Knot Tying During Warm Ischemia Time for Laparoscopic Partial Nephrectomy: The Video

2004 ◽  
Vol 171 (4S) ◽  
pp. 57-58
Author(s):  
Marcelo A. Orvieto ◽  
Gary W. Chien ◽  
R. Matthew Galocy ◽  
Mitchell H. Sokoloff ◽  
Gregory P. Zagaja ◽  
...  
Keyword(s):  
Partial Nephrectomy ◽  
Warm Ischemia ◽  
Warm Ischemia Time ◽  
Laparoscopic Partial Nephrectomy ◽  
Knot Tying ◽  
Ischemia Time

The First Assistant Sparing Technique Robot-Assisted Partial Nephrectomy Decreases Warm Ischemia Time While Maintaining Good Perioperative Outcomes

2012 ◽  
Vol 26 (11) ◽  
pp. 1448-1453 ◽  
Author(s):  
William T. Berg ◽  
Chad R. Rich ◽  
Gina M. Badalato ◽  
Christopher M. Deibert ◽  
Chris O. Wambi ◽  
...  
Keyword(s):  
Partial Nephrectomy ◽  
Warm Ischemia ◽  
Warm Ischemia Time ◽  
Perioperative Outcomes ◽  
Robot Assisted ◽  
Ischemia Time

Effect of Warm Ischemia Time During Laparoscopic Partial Nephrectomy on Early Postoperative Glomerular Filtration Rate

2009 ◽  
Vol 181 (6) ◽  
pp. 2438-2445 ◽  
Author(s):  
Guilherme Godoy ◽  
Vigneshwaran Ramanathan ◽  
Jamie A. Kanofsky ◽  
Rebecca L. O'Malley ◽  
Basir U. Tareen ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Partial Nephrectomy ◽  
Filtration Rate ◽  
Warm Ischemia ◽  
Warm Ischemia Time ◽  
Laparoscopic Partial Nephrectomy ◽  
Ischemia Time

scholarly journals Comparison of Transperitoneal and Retroperitoneal Laparoendoscopic Single-site Donor Nephrectomy

2020 ◽  
Author(s):  
Chung-Yu Lin ◽  
Ching-Chia Li ◽  
Hung-Lung Ke ◽  
Wen-Jeng Wu ◽  
Yii-Her Chou ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Blood Loss ◽  
Operation Time ◽  
Warm Ischemia ◽  
Donor Nephrectomy ◽  
Warm Ischemia Time ◽  
Single Site ◽  
Perioperative Outcomes ◽  
Ischemia Time ◽  
Laparoendoscopic Single Site

Abstract Background: Laparoscopic living-donor nephrectomy is the standard technique at high-volume renal transplant centers. Laparoendoscopic single-site donor nephrectomy (LESS-DN) is a relatively novel minimally invasive surgery, which was differed to transperitoneal and retroperitoneal approaches. We present a retrospective analysis of our single-institution donor nephrectomy series comparing the transperitoneal to retroperitoneal LESS-DN with regards to operative outcomes.Materials and Methods: Ten patients who underwent LESS-DN from 2017–2019 were enrolled at our center. The same surgeon performed all cases. The two approaches were compared retrospectively and evaluated for differences in perioperative outcomes, including operation time, console time, blood loss, graft warm ischemia time, postoperative pain, length of stay (LOS), wound size, postoperative pain, and renal function post LESS-DN at less than one year.Results: Total operating time (315 ± 82.69 vs. 191 ± 24.9 min, p = 0.016), console time (224 ± 74.15 vs. 110 ± 19.84 min, p = 0.016), and LOS (8.4 ± 1.82 vs. 4.8 ± 1.10 days, p = 0.013) were significantly longer in the transperitoneal group. The wound size (44 ± 3.81 vs. 68.2 ± 13.5 mm, p = 0.038) was significantly smaller in the transperitoneal group. There was no significant difference in other parameters, including blood loss, warm ischemia time, and postoperative pain from day one to day three.Conclusions: Retroperitoneal LESS-DN results in similar perioperative outcomes as transperitoneal LESS-DN without compromising donor safety, and while providing a faster operation time, console time, shorter LOS, and a trend toward a shorter warm ischemia time.

ELIMINATING KNOT TYING DURING WARM ISCHEMIA TIME FOR LAPAROSCOPIC PARTIAL NEPHRECTOMY

2004 ◽  
Vol 172 (6 Part 1) ◽  
pp. 2292-2295 ◽  
Author(s):  
MARCELO A. ORVIETO ◽  
GARY W. CHIEN ◽  
BRETT LAVEN ◽  
DAVID E. RAPP ◽  
MITCHELL H. SOKOLOFF ◽  
...  
Keyword(s):  
Partial Nephrectomy ◽  
Warm Ischemia ◽  
Warm Ischemia Time ◽  
Laparoscopic Partial Nephrectomy ◽  
Knot Tying ◽  
Ischemia Time

Warm ischemia time length during on-clamp partial nephrectomy: dose it really matter?

2021 ◽  
Author(s):  
Ali ABDEL RAHEEM ◽  
Ibrahim ALOWIDAH ◽  
Umberto CAPITANIO ◽  
Francesco MONTORSI ◽  
Alessandro LARCHER ◽  
...  
Keyword(s):  
Partial Nephrectomy ◽  
Warm Ischemia ◽  
Warm Ischemia Time ◽  
Ischemia Time ◽  
Time Length

scholarly journals Sutureless laparoscopic partial nephrectomy using fibrin gel reduces ischemia time while preserving renal function

2019 ◽  
Vol 91 (1) ◽  
pp. 30-34 ◽  
Author(s):  
Daniele Tiscione ◽  
Tommaso Cai ◽  
Lorenzo Giuseppe Luciani ◽  
Marco Puglisi ◽  
Daniele Mattevi ◽  
...  
Keyword(s):  
Renal Function ◽  
Partial Nephrectomy ◽  
Kidney Function ◽  
Charlson Comorbidity Index ◽  
Operative Time ◽  
Warm Ischemia ◽  
Control Group ◽  
Fibrin Gel ◽  
Ischemia Time ◽  
Comorbidity Index

Objectives: We evaluated the efficacy of sutureless laparoscopic partial nephrectomy (LPN), using a fibrin gel in order to minimize renal ischemia time and preserve kidney function. Materials and Methods: Nineteen patients (mean age 58.3 ± 7.1) undergoing sutureless LPN using a fbrin gel were compared with a control group consisting of 21 patients (mean age 57.9 ± 7.5) subjected to LPN with standard suturing. Intraand post-operative data for the two groups were compared. The following parameters were recorded: patient demographics, Charlson Comorbidity Index, tumor characteristics according to the RENAL score, warm ischemia and operative times, estimated blood loss, mean hospital stay, post-operative complications referring to the Clavien-Dindo classification, renal function parameters pathologic and follow-up data. The main outcome measure was renal ischemia time and maintenance of kidney function. Results: Median warm ischemia time was 13 minutes (range 11-19) in the group treated with fibrin gel and 19 (range 17- 29) in the control group, with a statistically significant difference (p < 0.001). The two groups were homogeneous in terms of the Charlson Comorbidity Index (4.6 vs 4.8) and RENAL score (9.6 vs 9.4). Median operative time differed significantly in the two groups, 183 minutes (range 145-218) in the group treated with fibrin gel and 201 (range 197-231) in the control group (p < 0.001). A negative surgical margin was reported in 18 patients (94.7%) in the group treated with fibrin gel and in 21 patients (100%) in the control group. No difference in renal function was found between the two groups. Conclusions: Sutureless LPN with fibrin gel can reduce warm ischemia and total operative time while preserving kidney function.

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