Comparison of radical nephrectomy techniques in one center: Minimal incision portless endoscopic surgery versus laparoscopic surgery

Soga, Norihito; Kato, Manabu; Masui, Satoru; Nishikawa, Kouhei; Hasegawa, Yoshihiro; Yumura, Yasushi; Kise, Hideaki; Arima, Kiminobu; Sugimura, Yoshiki

doi:10.1111/j.1442-2042.2008.02157.x

Cited by 10 publications

(9 citation statements)

References 14 publications

(27 reference statements)

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“…One prospective cohort study compared 'portless' (n = 14) and 3-port (n = 15) laparoscopic radical nephrectomy (Soga 2008) [26]. There were no local recurrences, but the study was small with a short follow-up (especially in the portless group: mean = 7.1 months; range 2.7-17.3) (plot 7.1, full report [13] [8] was a European-wide multi-centre RCT (n=772) comparing radical nephrectomy with or without complete lymph node dissection.…”

Section: 22f Single Port Laparoscopic Radical Nephrectomy Vs Lamentioning

confidence: 99%

Systematic Review of Oncological Outcomes Following Surgical Management of Localised Renal Cancer

MacLennan

Imamura

Lapitan³

et al. 2012

European Urology

300

174

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Context: Renal cell carcinoma (RCC) accounts for 2-3% of adult malignancies. There remain uncertainties over the oncological outcomes for the surgical management of localised RCC. Objective: To systematically review relevant literature comparing oncological outcomes of surgical management of localised RCC (T1-2N0M0). Evidence Acquisition: Relevant databases including MEDLINE, Embase and the Cochrane Library were searched up to October 2010, and an updated scoping search was performed up to January 2012. Randomised or quasi-randomised controlled trials (RCTs), prospective observational studies with controls, retrospective matched-pair studies, and comparative studies from well defined registries/databases were included. The main outcomes were overall survival, cancer-specific survival, recurrence and metastases. The Cochrane risk of bias (RoB) tool was used to assess RCTs and an extended version was used to assess Non Randomised Studies (NRS). The quality of evidence was assessed using GRADE. Evidence Synthesis: 4580 abstracts and 389 full text articles were assessed. 34 studies met the inclusion criteria (6 RCTs and 28 NRSs). Meta-analyses were planned but were deemed inappropriate due to data heterogeneity. There were high risks of bias and low quality evidence across the evidence base. Open radical nephrectomy and open partial nephrectomy showed similar cancer-specific and overall survival, but when both open and laparoscopic approaches are considered together the evidence showed improved survival for partial nephrectomy for tumours ≤4cm.Overall, the evidence suggests either equivalent or better survival with partial nephrectomy. Laparoscopic radical nephrectomy offered equivalent survival to open radical nephrectomy, and all laparoscopic approaches achieved equivalent survival. Open and laparoscopic partial nephrectomy achieved equivalent survival. The issue of ipsilateral adrenalectomy or complete lymph node dissection with radical nephrectomy or partial nephrectomy remains unresolved. Conclusions: The evidence base suggests localised RCC are best managed by nephron sparing surgery where technically feasible. However, the current evidence base has significant limitations due to studies of low methodological quality marked by high risks of bias.

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Section: 22f Single Port Laparoscopic Radical Nephrectomy Vs Lamentioning

confidence: 99%

Systematic Review of Oncological Outcomes Following Surgical Management of Localised Renal Cancer

MacLennan

Imamura

Lapitan³

et al. 2012

European Urology

300

174

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“…Operative time and blood loss are similar to those in open surgery and complications including blood transfusion are very rare 18 . Postoperative data, days to oral feeding and days to walking are reported to be equal or sooner compared with laparoscopic surgery, 18,42 and surgical site infection is extremely rare despite the lack of use of prophylactic antibacterial agents 43 . Cancer‐specific survival and recurrence‐free survival are similar to those after open surgery 41 .…”

Section: Framework Of the Mies Systemmentioning

confidence: 87%

Gasless single‐port access endoscopic surgery in urology: Minimum incision endoscopic surgery, MIES

et al. 2009

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Minimum incision endoscopic surgery (MIES) is a gasless, single-port access, cost-effective, and minimally invasive surgery that has been in development since the late 1990s. Use of MIES has steadily increased in Japan and Asia and has been introduced into Europe and the USA. In 2006, MIES was certified by the Japanese government as an advanced surgery and since 2008 it has been covered by the Japanese universal health insurance system as a new surgical technique. Briefly, MIES involves an initial minimum incision (a single port) that permits extraction of the target specimen. A wide working space through the port is then made by separating the anatomical plane extraperitoneally. This is maintained with special retractors instead of gas insufflation. All instruments including an endoscope are inserted through the port and the operation is completed. The size of the port can be tailored to the situation if necessary, which contributes to preclusion of patient selection. The procedure uses only two disposable devices that are inexpensive, resulting in low equipment costs. Surgeons have the benefits of magnified vision through endoscopy as well as stereovision and panoramic vision of naked eyes through the port, which reduces the technical demands of the procedure. Techniques for two basic MIES procedures allow MIES to be performed for most urological organs and in extraordinary cases by their modifications. Thus, the MIES system permits minimally invasive surgery without use of CO2 gas, which is ideal from medical, environmental and economic perspectives, is cost-effective and minimizes patient selection.

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“…In Japan, patients with ACDK-RCC have been increasing now. The cost of disposable instruments in this operation is much lower than that in LRN 47 . Based on these advantages, gasless single-port retroperitoneal RN seems to be ideal minimally invasive surgery for ESRD patients.…”

Section: Minimum Incision Endoscopic Surgery Mies For Rcc ; Gasless mentioning

confidence: 94%

Renal Cell Carcinoma in Dialysis Patients with End Stage Renal Disease: Focus on Surgery and Pathology

Masuda¹,

Kihara²,

Fujii³

et al. 2011

Hemodialysis - Different Aspects

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Comparison of radical nephrectomy techniques in one center: Minimal incision portless endoscopic surgery versus laparoscopic surgery

Cited by 10 publications

References 14 publications

Systematic Review of Oncological Outcomes Following Surgical Management of Localised Renal Cancer

Systematic Review of Oncological Outcomes Following Surgical Management of Localised Renal Cancer

Gasless single‐port access endoscopic surgery in urology: Minimum incision endoscopic surgery, MIES

Renal Cell Carcinoma in Dialysis Patients with End Stage Renal Disease: Focus on Surgery and Pathology

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