A Simple Method for Ensuring Resection Margins During Laparoscopic Partial Nephrectomy: The Intracorporeal Ultrasonography

Doerfler, A.; Oitchayomi, Abeni; Tillou, X.

doi:10.1016/j.urology.2014.07.025

Cited by 18 publications

(11 citation statements)

References 2 publications

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“…In line with a previous reports of surgical specimen (ex vivo) US in assessing margin status for PN, we confirm the safety and efficacy of this approach in our single-institution series [12,13]. Patient characteristics, operative indications, tumour and margin size were comparable to previous series [9,14].…”

Section: Discussionsupporting

confidence: 92%

“…Surgical specimen (ex vivo) US of the PN specimen pseudocapsule has previously been reported in one study to be feasible and efficient at determining the accuracy of margin status [12]. This technique has also been reported in another recent study performed in 12 patients undergoing laparoscopic PN [13]. In this study, we report our experience with a similar technique at a single institution.…”

Section: Introductionmentioning

confidence: 67%

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Intraoperative and surgical specimen (ex vivo) ultrasound in the assessment of margins at partial nephrectomy

et al. 2015

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 67%

Intraoperative and surgical specimen (ex vivo) ultrasound in the assessment of margins at partial nephrectomy

et al. 2015

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“…US sensitivity and specificity were 100% and 97%, respectively. Other study was done on 12 patients who underwent laparoscopic PN:[7] the surgical margins of the specimens were controlled intracorporeally by US before performing the hemostasis. Eleven cases had negative margins, and one case had positive surgical margins, and an extra resection was made.…”

Section: Discussionmentioning

confidence: 99%

“…The duration of US control was short and can be done immediately after the removal of the tumor and before hemostasis. [7]…”

Section: Discussionmentioning

confidence: 99%

Intraoperative ultrasound control of surgical margins during partial nephrectomy

et al. 2016

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Aims:To evaluate a simple and fast technique to ensure negative surgical margins on partial nephrectomies, while correlating margin statuses with the final pathology report.Subjects and Methods:This study was conducted for patients undergoing partial nephrectomy (PN) with T1–T2 renal tumors from January 2010 to the end of December 2015. Before tumor removal, intraoperative ultrasound (US) localization was performed. After tumor removal and before performing hemostasis of the kidney, the specimens were placed in a saline solution and a US was performed to evaluate if the tumor's capsule were intact, and then compared to the final pathology results.Results:In 177 PN(s) (147 open procedures and 30 laparoscopic procedures) were performed on 147 patients. Arterial clamping was done for 32 patients and the mean warm ischemia time was 19 ± 6 min. The mean US examination time was 41 ± 7 s. The US analysis of surgical margins was negative in 172 cases, positive in four, and in only one case it was not possible to conclude. The final pathology results revealed one false positive surgical margin and one false negative surgical margin, while all other margins were in concert with US results. The mean tumor size was 3.53 ± 1.43 cm, and the mean surgical margin was 2.8 ± 1.5 mm.Conclusions:The intraoperative US control of resection margins in PN is a simple, efficient, and effective method for ensuring negative surgical margins with a small increase in warm ischemia time and can be conducted by the operating urologist.

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“…Intraoperative ultrasonography has long been used as an intraoperative imaging technique for tumor localization and delineation during PN, but because the probe stays in contact with the tissue, it is not practical for real-time guidance during resection, and only a few studies report on the intraoperative assessment of surgical margins within the United States. [17][18][19][20] For these studies, ultrasonography performed intraoperatively during PN identified NSMs with 100% sensitivity and 97% to 100% specificity when compared with the final histopathological examination. [17][18][19][20] While near-infrared (NIR) fluorescence is useful for assessing the surgical cavity and assessing tissue perfusion, the technology has limited tissue penetration depth and requires contrast agents, which can be problematic due to patient intolerance and impact on surgical workflows.…”

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confidence: 99%

Visible near infrared reflectance molecular chemical imaging of human ex vivo carcinomas and murine in vivo carcinomas

et al. 2020

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Significance: A key risk faced by oncological surgeons continues to be complete removal of tumor. Currently, there is no intraoperative imaging device to detect kidney tumors during excision. Aim: We are evaluating molecular chemical imaging (MCI) as a technology for real-time tumor detection and margin assessment during tumor removal surgeries. Approach: In exploratory studies, we evaluate visible near infrared (Vis-NIR) MCI for differentiating tumor from adjacent tissue in ex vivo human kidney specimens, and in anaesthetized mice with breast or lung tumor xenografts. Differentiation of tumor from nontumor tissues is made possible with diffuse reflectance spectroscopic signatures and hyperspectral imaging technology. Tumor detection is achieved by score image generation to localize the tumor, followed by application of computer vision algorithms to define tumor border. Results: Performance of a partial least squares discriminant analysis (PLS-DA) model for kidney tumor in a 22-patient study is 0.96 for area under the receiver operating characteristic curve. A PLS-DA model for in vivo breast and lung tumor xenografts performs with 100% sensitivity, 83% specificity, and 89% accuracy. Conclusion: Detection of cancer in surgically resected human kidney tissues is demonstrated ex vivo with Vis-NIR MCI, and in vivo on mice with breast or lung xenografts.

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A Simple Method for Ensuring Resection Margins During Laparoscopic Partial Nephrectomy: The Intracorporeal Ultrasonography

Cited by 18 publications

References 2 publications

Intraoperative and surgical specimen (ex vivo) ultrasound in the assessment of margins at partial nephrectomy

Intraoperative and surgical specimen (ex vivo) ultrasound in the assessment of margins at partial nephrectomy

Intraoperative ultrasound control of surgical margins during partial nephrectomy

Visible near infrared reflectance molecular chemical imaging of human ex vivo carcinomas and murine in vivo carcinomas

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