scholarly journals Ex-vivo nephron-sparing surgery and autotransplantation for renal tumours: Revisited

2014 ◽  
Vol 8 (9-10) ◽  
pp. 728 ◽  
Author(s):  
George P Abraham ◽  
Avinash T Siddaiah ◽  
Krishnamohan Ramaswami ◽  
Datson George ◽  
Krishanu Das
Keyword(s):  
Operative Time ◽  
Ex Vivo ◽  
Laparoscopic Approach ◽  
Nephron Sparing Surgery ◽  
Study Patient ◽  
Renal Tumours ◽  
Nephron Sparing ◽  
Renal Autotransplantation ◽  
Patient Profiles

Introduction: We studied the feasibility of ex-vivo nephron-sparing surgery and autotransplantation for complex renal tumours. We also studied the role of laparoscopy in these situations.Methods: All patients who underwent renal autotransplantation for renal tumour at our centre were included in this retrospective study. Patient profiles were recorded in detail. Operative and postoperative details were also recorded.Results: Our series includes 3 patients. Two patients had complex renal cell carcinoma and 1 patient had bilateral large angiomyolipoma. In the first 2 patients, laparoscopic approach was used for nephrectomy. Operative time for case 1, 2 and 3 was 5.5, 4.5, 8 (right side) and 6 (left side) hours, respectively. Cold ischemia time was 110, 90, 150 and 125 minutes, respectively. One patient required temporary postoperative hemodialysis.Conclusion: Ex-vivo nephron-sparing surgery and autotransplantation still remain a viable option for complex renal tumours. It offers satisfactory renal functional outcome with acceptable morbidity. The laparoscopic approach should be used whenever possible to reduce morbidity.

scholarly journals The Role of Nephron-Sparing Surgery (NSS) for Renal Tumours >4 cm

10.5772/26723 ◽  
2012 ◽  
Author(s):  
Amlie Parisel ◽  
Frederic Baekelandt ◽  
Hein Van ◽  
Steven Joniau
Keyword(s):  
Nephron Sparing Surgery ◽  
Renal Tumours ◽  
Nephron Sparing

scholarly journals Familial Adenomatous Polyposis and Desmoid Tumor Treated with Multivisceral Transplantation and Kidney Autotransplantation: Case Report and Literature Review

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Libor Janousek ◽  
Robert Novotny ◽  
Michal Kudla ◽  
Martin Oliverius ◽  
Petr Wohl ◽  
...  
Keyword(s):  
Ex Vivo ◽  
Deceased Donor ◽  
Multiple Organ ◽  
Nephron Sparing Surgery ◽  
Tumour Resection ◽  
Adenomatous Polyposis ◽  
Multivisceral Transplantation ◽  
Nephron Sparing ◽  
One Year ◽  
Kidney Autotransplantation

Introduction. Desmoid tumours (DT) are commonly associated with Gardener’s syndrome. Their surgical resection may be complicated by their close proximity to major vessels, multiple organ involvement, and frequent local recurrence. Multivisceral transplantation (MVTx) is an alternative treatment for patients with intestinal and liver failure. In patients with DT closely associated with renal structures but without end-stage kidney disease, concomitant excision of the patient’s own kidney, ex vivo tumour resection with nephron-sparing surgery, or autotransplantation has been proposed. Case Presentation. A 36-year-old Caucasian female weighing 60 kg with Gardener’s syndrome with a history of abdominal surgery was presented to our department with progressive abdominal distention associated with paroxysmal pain. With the use of CT, the patient was diagnosed with a mass arising from the mesenterial region. The patient had normal kidney function and nonalcoholic steatohepatitis. The patient was indicated for MVTx. Management and Outcome. After 16 months on the waiting list, the patient received a multivisceral graft from a deceased donor. Following the restoration of graft vascular flow, the patient’s right kidney was removed and the DT dissected ex vivo before autotransplantation into the right pelvic fossa. The patient received immunosuppressive, antithrombotic, and antibiotic treatment. There was no acute rejection, though the patient experienced pulmonary infection, dysphagia, and oesophageal reflux with fungal infection. The patient had required temporary dialysis for acute renal failure for 75 days. One year after the surgery, nausea and violent vomiting caused delayed gastric emptying caused by spastic pylorus. Clinical improvement was achieved using gastric peroral endoscopic myotomy (G-POEM). Conclusion. MVTx with kidney autotransplantation is a feasible treatment option in patients with familiar adenomatous polyposis complicated by an abdominal DT. Precise tumour dissection with nephron-sparing surgery was carried ex vivo. G-POEM was used to relieve MVTx-related gastroparesis. The patient had no disease reoccurrence after one-year follow-up.

349Elective nephron sparing surgery for renal tumours — Long-term outcome

2005 ◽  
Vol 4 (3) ◽  
pp. 90
Author(s):  
S. Pahemik ◽  
R. Gillitzer ◽  
C. Hampel ◽  
S. Melchior ◽  
J. Thuroff
Keyword(s):  
Nephron Sparing Surgery ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Renal Tumours ◽  
Nephron Sparing

Elective open nephron-sparing surgery for renal masses: Single-center experience with 223 consecutive patients

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e16139-e16139
Author(s):  
F. Francesca ◽  
G. Pomara ◽  
G. Campo ◽  
P. Casale
Keyword(s):  
Postoperative Bleeding ◽  
Oncologic Outcome ◽  
Nephron Sparing Surgery ◽  
Consecutive Series ◽  
Renal Masses ◽  
Single Center Experience ◽  
Nephron Sparing ◽  
Urinary Fistulas

e16139 Background: To present our experience with elective, open, nephron-sparing surgery for renal masses in a contemporary, consecutive series. Methods: In this retrospective study, records of all patients who underwent elective nephron-sparing surgery (E-NSS) between March 1997 and December 2007 at our institution were reviewed. The preoperative workup included laboratory analysis, renal ultrasonography and abdominal computed tomography. The histological findings, complications, and oncologic outcome were studied. Results: A total of 231 E-NSS were performed in 223 patients (82 females,141males; mean age 64 years). 62 “hot ischemia” procedures and 169 “cold ischemia”. The mean tumor size was 4.6 cm (1.1–12cm). 52 patients presented renal masses > 4cm. Renal cell carcinoma was present in 177 patients (76.6%), benign renal masses were diagnosed in in 54 pazienti (23.3%): angiomyolipoma (35%), oncocytoma (40%), complicated cyst (25%). Worthy of note among these 54 patients, pre-operative diagnosis was present in 12 patients. Moreover, 17 benign lesions (31%) were > 4 cm. Complication rate was 5.3% (12 pts): splenectomy (2.2%), nephrectomy because of postoperative bleeding (0.8%), urinary fistulas (0.8%). After a median follow-up of 84 months (range 5 to 120), no patient had developed local recurrence, 19 (8.9%) died for other causes, 2 (0.9%) died for other tumor. Conclusions: The results of this contemporary, monocenter experience underline the role of open, elective, nephron-sparing surgery for patients with renal masses, confirming good results even for renal masses > 4cm. These conclusions are particularly important considering that benign histologic findings were present in almost one forth of patients. No significant financial relationships to disclose.

87 Morbidity, functional and oncological outcomes after nephron sparing surgery for cT2 renal tumours

2013 ◽  
Vol 12 (1) ◽  
pp. e87-e88
Author(s):  
P. Bigot ◽  
J.F. Hetet ◽  
T. Fardoun ◽  
J. Rouffilange ◽  
E. Xylinas ◽  
...  
Keyword(s):  
Nephron Sparing Surgery ◽  
Oncological Outcomes ◽  
Renal Tumours ◽  
Nephron Sparing
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