A Propensity Score-Matched Comparison Between Sutureless and Suture Techniques in Laparoscopic Nephron-Sparing Surgery: A Retrospective Non-Randomized Observational Study

Jin, Dachun; Ren, Dong; Zhang, Junyong; Xu, Gezhi; Ge, Chengguo; Jiang, Qing; Wang, Delin; Zhang, Weili; Zhang, Yuanfeng

doi:10.1089/lap.2020.0187

Cited by 13 publications

(8 citation statements)

References 16 publications

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“…After excluding the study of Jianfei Ye et al (13), the heterogeneity of warm ischemia time decreased (I 2 from 97.5% to 25.3%), but the results were consistent with previous studies. In addition, in comparing operation time, after excluding the study of Dachun Jin et al (10), the results were also consistent with the previous studies.…”

Section: Resultssupporting

confidence: 87%

“…Sutureless PN seems to reduce the potential impact on postoperative renal function, but no difference in postoperative eGFR was found in our study. In the study of Zhang et al and Jin et al, it was shown that the decline in renal function after sutureless PN was lower than that after suture PN (10,11). Due to the different diagnostic criteria in the included studies, we could not evaluate the difference in renal function decline to prove that sutureless technique is better than suture technique in renal function protection.…”

Section: Discussionmentioning

confidence: 94%

“…In recent years, some urologists have been focused on sutureless PN and tried to prove its safety and feasibility (2,(8)(9)(10)(11)(12)(13)(14)(15)(16)(17). Without suture, the difficulty of operation is reduced, and the operation time is saved.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Sutureless Versus Suture Partial Nephrectomy for Clinical T1 Renal Cell Carcinoma: A Meta-Analysis of Retrospective Studies

Zhang

Che

et al. 2021

Front. Oncol.

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BackgroundPartial nephrectomy (PN) is the recommended treatment for T1 renal cell carcinoma (RCC). Compared with suture PN, sutureless PN reduces the difficulty and time of operation, but the safety and feasibility have been controversial. This meta-analysis was conducted to compare the function and perioperative outcomes of suture and sutureless PN for T1 RCC.MethodsSystematic literature review was performed up to April 2021 using multiple databases to identify eligible comparative studies. According to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) criteria, identification and selection of the studies were conducted. Meta-analysis was performed for studies comparing suture to sutureless PN for both T1a and T1b RCC. In addition, subgroup analysis was performed on operation time, warm ischemia time, estimated blood loss, and postoperative complications. Sensitivity analysis was used in analysis with high heterogeneity (operation time and estimated blood loss).ResultsEight retrospective studies were included with a total of 1,156 patients; of the 1,156 patients, 499 received sutureless PN and 707 received suture PN. The results showed that sutureless PN had shorter operative time (I2 = 0%, P < 0.001), warm ischemia time (I2 = 97.5%, P < 0.001), and lower clamping rate (I2 = 85.8%, P = 0.003), but estimated blood loss (I2 = 76.6%, P = 0.064) had no difference. In the comparison of perioperative outcomes, there was no significant difference in postoperative complications (I2 = 0%, P = 0.999), positive surgical margins (I2 = 0%, P = 0.356), postoperative estimated glomerular filtration rat (eGFR) (I2 = 0%, P = 0.656), and tumor recurrence (I2 = 0%, P = 0.531).ConclusionsIn T1a RCC with low RENAL score, sutureless PN is a feasible choice, whereas it should not be overestimated in T1b RCC.

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Section: Resultssupporting

confidence: 87%

Section: Discussionmentioning

confidence: 94%

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Comparison of Sutureless Versus Suture Partial Nephrectomy for Clinical T1 Renal Cell Carcinoma: A Meta-Analysis of Retrospective Studies

Zhang

Che

et al. 2021

Front. Oncol.

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“…According to related research (23) and practice, traditional laparoscopic surgery has been improved, and it is proved that zero ischemia (18,24) and sutureless (25)(26)(27) LPN technique is feasible for the treatment of small, exogenous and peripheral RCC. Compared with the traditional renal artery occlusion, there is no signi cant difference in the sample statistics of IBL.…”

Section: Discussionmentioning

confidence: 99%

The Application of R.E.N.A.L. Nephrometry Score In Laparoscopic Partial Nephrectomy With Zero Ischemia And Sutureless

Chen

et al. 2021

Preprint

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Background: To evaluate the application of R.E.N.A.L. nephrometry score (RNS) in laparoscopic partial nephrectomy (LPN) with zero ischemia and sutureless surgery, and to explore the efficacy and safety of zero ischemia and seamless LPN in the treatment of renal cell carcinoma.Methods: The clinical data of 67 patients with renal cell carcinoma treated by LPN in the affiliated Hospital of Guizhou Medical University from January 2016 to July 2020 were analyzed retrospectively. The patients were divided into renal artery occlusion group (n=31) and non-occlusion group (n=36). All cases were divided according to their RNS (low, moderate, and high), and the perioperative condition, postoperative complications, postoperative recovery and changes of renal function in the two groups were analyzed.Results: According to the RNS, all cases were classified in low-complex. Both groups successfully completed the operation without operative complications. Compared with the renal artery occlusion group, the non-occlusion group had a shorter operation time (35.51±20.48 min), shorter hospital stay (6.72±4.39 d), and no significant difference in intraoperative blood loss(50.39±30.19 ml). During the 6-month follow-up, the creatinine value of the renal function in the non-occlusion group (78.47±10.98μmol/L) was lower than that in the occlusion group(98.21±8.06μmol/L).Conclusion: Zero-ischemia sutureless LPN technique can effectively reduce the time of ischemia and avoid renal ischemia-reperfusion injury. This surgical technique may be a feasible surgical method for the treatment of low RNS renal cell carcinoma.

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“…Traditional partial nephrectomy performs a double-layer suture (inner and cortical) during renorrhaphy [4][5][6], known as standard suture, which may damage renal vessels, reduce renal parenchyma, and increase warm ischemia time resulting in renal dysfunction [7]. Recently, there has been a growing application of sutureless during renorrhaphy in laparoscopic and roboticassisted partial nephrectomy [8][9][10]. Sutureless uses various hemostatic materials and surgical equipment instead of suturing during renorrhaphy to achieve the purpose of hemostasis [11,12].…”

Section: Introductionmentioning

confidence: 99%

The Outcome of Sutureless in Partial Nephrectomy: A Systematic Review and Meta-Analysis

Liu

Shi

et al. 2022

BioMed Research International

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Purpose. To compare the effect of sutureless versus standard suture (double-layer suture) during renorrhaphy in laparoscopic or robotic-assisted partial nephrectomy on perioperative and renal function outcomes. Methods. PubMed, Embase, and other sources were searched for randomized controlled trials or retrospective studies comparing sutureless partial nephrectomy versus standard suture partial nephrectomy. A systematic review and meta-analysis were performed by two reviewers independently. Results. Five retrospective studies were included with a total of 634 patients. The results showed that there was a significant difference in the decline of estimated glomerular filtration rate ( I 2 = 98.5 % ; WMD, -4.19 ml/min; 95% CI, -7.64 to -0.73; P < 0.001 ) and no significant difference in postoperative complications ( I 2 = 0 ; RR, 1.31; 95% CI, 0.61 to 2.81; P = 0.623 ). A significant advantage in terms of operating time ( I 2 = 53.9 % ; WMD, -29.08 min; 95% CI, -33.06 to -25.10; P = 0.069 ) and warm ischemia time ( I 2 = 38.5 % ; WMD, -6.17 min; 95% CI, -6.99 to -5.36; P = 0.165 ) favored sutureless, while there was no significant difference in blood loss ( I 2 = 58.1 % ; WMD, 3.10 ml; 95% CI, -39.18 to 45.38; P = 0.049 ). Conclusion. Sutureless during renorrhaphy is feasible and safe compared with standard suture. Sutureless can shorten the operating time and warm ischemia time without increasing postoperative complications, and thus, it protects renal function.

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A Propensity Score-Matched Comparison Between Sutureless and Suture Techniques in Laparoscopic Nephron-Sparing Surgery: A Retrospective Non-Randomized Observational Study

Cited by 13 publications

References 16 publications

Comparison of Sutureless Versus Suture Partial Nephrectomy for Clinical T1 Renal Cell Carcinoma: A Meta-Analysis of Retrospective Studies

Comparison of Sutureless Versus Suture Partial Nephrectomy for Clinical T1 Renal Cell Carcinoma: A Meta-Analysis of Retrospective Studies

The Application of R.E.N.A.L. Nephrometry Score In Laparoscopic Partial Nephrectomy With Zero Ischemia And Sutureless

The Outcome of Sutureless in Partial Nephrectomy: A Systematic Review and Meta-Analysis

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