A model for assuring clamping success during laparoscopic partial nephrectomy with segmental renal artery clamping

Xiao, Li; Huang, Yuan; Liu, Wangyan; Li, Pu; Tang, Lijun; Xu, Yi; Li, Jie; Lv, Qiang; Liu, Hua; Shao, Pengfei; Qin, Chao; Wang, Zengjun

doi:10.1007/s00345-016-1785-7

Cited by 4 publications

(11 citation statements)

References 16 publications

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“…For clarity, X refers to the depth of the clamping point inside the kidney. Based on the equation describing the clamping assurance of a certain artery based on our previous research and complex calculations 16 , 1 point is awarded for a score of X from 0 cm to 1.1 cm, 2 points are awarded for a score of 1.2 cm to 1.5 cm, while 3 points are awarded for a distance more than 1.6 cm. Similarly, Y refers to the distance from the clamping position to the renal midline.…”

Section: Resultsmentioning

confidence: 99%

“…In addition, they also established a standard renal hilar approach for SRAC to standardize the surgery 13 . In 2016, a model for assuring the clamping success of SRAC was developed 16 . This model is beneficial for the surgeon while designing an SRAC program and can distinguish the clamping artery that provides high assurance from those providing low assurance and can help surgeons to choose a suitable artery for clamping.…”

Section: Discussionmentioning

confidence: 99%

“…This variable describes the location of the clamping position; before using this system, the target artery and it’s clamping position should be identified on the computed tomography arteriography image. The protocol used to identify the clamping position has been described in our previous research 16 . This variable contains two parameters, X and Y. X refers to the depth of the clamping point inside the renal, and larger values of X tend to increase the difficulty of clamping; Y refers to the distance from the clamping position to the kidney midline.…”

Section: Discussionmentioning

confidence: 99%

“…An equation involving the clamping assurance of a certain artery was used in the development of the scoring system. This equation has been described in our previous report 16 .…”

Section: Methodsmentioning

confidence: 96%

“…The procedure of SRAC before LPN and three guiding rules for the clamping program have been described in detail in our early research 11 – 13 , 16 . First, patients were administered general anesthesia and placed in the lateral decubitus position.…”

Section: Methodsmentioning

confidence: 99%

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The C.L.A.M.P. Nephrometry score: A system for preoperative assessment of laparoscopic partial nephrectomy with Segmental Renal Artery Clamping

Wang

Chen

Qin

et al. 2018

Sci Rep

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Laparoscopic partial nephrectomy with segmental renal artery clamping is associated with a less warm ischemic injury and better postoperative affected renal function compared with main renal artery clamping. However, its indication remains unclear. We established a standardized nephrometry scoring system (The C.L.A.M.P. Nephrometry Score) to evaluate its flexibility in preoperative assessment. This scoring system based on 5 components. The ranking (C)oefficient of each score and the (L)ocation of the clamping position of the target artery and areas of the target artery entering the renal sinus: (A)nterior boundary, (M)ulti-boundary and (P)osterior boundary. We applied this system to analyze data from 106 consecutive patients who underwent SRAC during LPN and divided these patients into 3 groups based on their C.L.A.M.P. scores. The rate of conversion to main renal artery clamping and clamping success rate and the affected side GFR reduction showed significant differences among the groups (P < 0.001). However, parameters such as blood loss, Warm ischemia time and postoperative hospitalization were not significantly different. The C.L.A.M.P. nephrometry score shows strong ability in distinguishing different complexities of artery characteristics and plays a promising role in identifying patients who are suitable for the SRAC technique.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…An equation involving the clamping assurance of a certain artery was used in the development of the scoring system. This equation has been described in our previous report 16 .…”

Section: Methodsmentioning

confidence: 96%

Section: Methodsmentioning

confidence: 99%

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The C.L.A.M.P. Nephrometry score: A system for preoperative assessment of laparoscopic partial nephrectomy with Segmental Renal Artery Clamping

Wang

Chen

Qin

et al. 2018

Sci Rep

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Factors affecting the use of a three‐dimensional model during robot‐assisted partial nephrectomy

Yamazaki,

Takayama,

Sugihara

et al. 2024

Asian J Endoscop Surgery

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IntroductionThis study aimed to identify cases that require a three‐dimensional‐printed kidney model in robot‐assisted partial nephrectomy.MethodsWe enrolled 93 patients undergoing robot‐assisted partial nephrectomy for renal tumors at a single institution between November 2018 and May 2021. The endpoints were how often and how long the surgeon consulted the three‐dimensional‐printed model, determined using intraoperative video. Multivariate analyses of the endpoints were adjusted by preoperative patient and kidney characteristics, including renal vascular complexity that was defined as the number of vascular branches penetrating the surface tangential to the ventral side of the kidney.ResultsOf the 93 cases, the median frequency and duration of intraoperative three‐dimensional‐printed model consultation were four times and 39 s, respectively. The multivariate linear regression analyses showed that the frequency of intraoperative three‐dimensional‐printed model consultation by the surgeon was significantly related to the complexity of the arterial structure (≥4 branches), presence of hilar tumor, and high Mayo Adhesive Probability score; the regression coefficients were 1.81, 2.79, and 1.34, respectively. All p‐values were ≤.03. The duration of the three‐dimensional‐printed model consultation was significantly related to the complexity of the arterial structure (≥4 branches) and the presence of hilar tumor; the regression coefficients were 21.6, and 29.0 s, respectively. All p‐values were <.01.ConclusionDuring robot‐assisted partial nephrectomy, a three‐dimensional‐printed model would be helpful in cases with a complex arterial structure or hilar tumor.

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Comparative study on the curative effect of laparoscopic nephron sparing surgery and renal functions under selective segmental renal artery clamping and main renal artery clamping

et al. 2019

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Objective: To discuss the clinical effect and safety evaluation of laparoscopic nephron sparing surgery (LNSS) under selective segmental renal artery clamping (SSRAC) and main renal artery clamping (MRAC). Methods: Eighty-four patients with T1 localized renal tumors who were admitted and treated from October 2017 to October 2018 were retrospectively analyzed, and they were classified into the S group (42 patients) and M group (42 patients). The patients in the S group received LNSS under SSRAC, while the patients in the M group received LNSS under MRAC. The duration of the operation, amount of intraoperative blood loss, intraoperative warm ischemia time, duration of postoperative hospital stay and positive rate of incisal edge; the serum creatinine and blood urea nitrogen values before and after the operation; and the occurrence rates of intraoperative and postoperative complications were compared. Results: All operations were completed smoothly. No patients had a positive incisal edge, and no patients were converted to MRAC during the operation. The duration of the operation and the amount of intraoperative blood loss increased in the S group compared with the M group. The differences were statistically significant (P <0.05). The differences in the intraoperative warm ischemia time, postoperative drainage and duration of postoperative hospital stay in both groups had no statistical significance (P >0.05). The differences in serum creatinine (SCr) and blood urea nitrogen (BUN) in both groups before the operation had no statistical significance (P >0.05). The SCr and BUN levels significantly increased 1 d and 1 m after the operation. The SCr and BUN levels 1 d and 1 m after the operation were significantly lower in the S group than in the M group, and the differences were statistically significant (P <0.05). The differences in the occurrence rates of intraoperative and postoperative complications in both groups had no statistical significance (P >0.05). Conclusion: SSRAC is a new renal artery clamping technology, and its curative effect on LNSS patients is significant. In addition, SSRAC has high safety and little influence on renal functions. doi: https://doi.org/10.12669/pjms.36.2.1505 How to cite this:Liu YH, Dai HT, Liu CM, Wang ZY, Zheng J. Comparative study on the curative effect of laparoscopic nephron sparing surgery and renal functions under selective segmental renal artery clamping and main renal artery clamping. Pak J Med Sci. 2020;36(2):---------. doi: https://doi.org/10.12669/pjms.36.2.1505 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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A model for assuring clamping success during laparoscopic partial nephrectomy with segmental renal artery clamping

Abstract: The model for assuring clamping success was helpful in designing an SRAC program and thus benefiting the LPN procedure.

Cited by 4 publications

References 16 publications

The C.L.A.M.P. Nephrometry score: A system for preoperative assessment of laparoscopic partial nephrectomy with Segmental Renal Artery Clamping

The C.L.A.M.P. Nephrometry score: A system for preoperative assessment of laparoscopic partial nephrectomy with Segmental Renal Artery Clamping

Factors affecting the use of a three‐dimensional model during robot‐assisted partial nephrectomy

Comparative study on the curative effect of laparoscopic nephron sparing surgery and renal functions under selective segmental renal artery clamping and main renal artery clamping

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