Health-related quality of life after hand-assisted laparoscopic and open radical nephrectomies of renal cell carcinoma

Jiang, Jianping; Zheng, Xiangyi; Qin, Jie; Zheng, Mingfeng; Mao, Qinan; Zhang, Zhigen; Cai, Shibo; Xie, Liping

doi:10.1007/s11255-008-9429-5

Cited by 13 publications

(16 citation statements)

References 16 publications

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“…Quality of life (QOL) was set to 1 for patients without a tumor. Likewise, based on previous literature, QOL for patients with a localized tumor was set to 0.97, as surgery and possible complications lead to a reduction of QOL [18]. In accordance with literature, the QOL of patients with a metastasized tumor was set to 0.67 [4].…”

Section: Costs and Utilitiesmentioning

confidence: 99%

Comparison of Magnetic Resonance Imaging and Contrast-Enhanced Ultrasound as Diagnostic Options for Unclear Cystic Renal Lesions: A Cost-Effectiveness Analysis

et al. 2020

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Purpose Correct differentiation between malignant and benign incidentally found cystic renal lesions has critical implications for patient management. In several studies contrast-enhanced ultrasound (CEUS) showed higher sensitivity with respect to the accurate characterization of these lesions compared to MRI, but the cost-effectiveness of CEUS has yet to be investigated. The aim of this study was to analyze the cost-effectiveness of CEUS as an alternative imaging method to MRI for the characterization of incidentally found cystic renal lesions. Materials and Methods A decision model including the diagnostic modalities MRI and CEUS was created based on Markov simulations estimating lifetime costs and quality-adjusted life years (QALYs). The recent literature was reviewed to obtain model input parameters. The deterministic sensitivity of diagnostic parameters and costs was determined and probabilistic sensitivity analysis using Monte-Carlo Modelling was applied. Willingness-to-pay (WTP) was assumed to be $ 100 000/QALY. Results In the base-case scenario, the total costs for CEUS were $9654.43, whereas the total costs for MRI were $9675.03. CEUS resulted in an expected effectiveness of 8.06 QALYs versus 8.06 QALYs for MRI. Therefore, from an economic point of view, CEUS was identified as an adequate diagnostic alternative to MRI. Sensitivity analysis showed that results may vary if CEUS costs increase or those of MRI decrease. Conclusion Based on the results of the analysis, the use of CEUS was identified as a cost-effective diagnostic strategy for the characterization of incidentally found cystic renal lesions.

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Section: Costs and Utilitiesmentioning

confidence: 99%

Comparison of Magnetic Resonance Imaging and Contrast-Enhanced Ultrasound as Diagnostic Options for Unclear Cystic Renal Lesions: A Cost-Effectiveness Analysis

et al. 2020

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“…Clinical studies have shown clear benefits in regard to earlier return to activities, resumption of oral intake, and other peri-operative outcomes with minimally invasive surgery 5, 11 . Our results show that these approaches have measurable short-term patient-reported QOL benefits, but the differences disappear after a few months.…”

Section: Discussionmentioning

confidence: 99%

“…Laparoscopic radical nephrectomy is performed commonly at both community and academic centers, even at the risk of overutilization for tumors which may be amenable to nephron-sparing surgery 9, 10 . A small retrospective study of patients 1 year after undergoing laparoscopic versus open radical nephrectomy showed no significant difference in QOL 11 , while a prospective study of the same procedures noted QOL benefits among the laparoscopic group 12 .…”

mentioning

confidence: 96%

Comprehensive Assessment of Quality of Life and Psychosocial Adjustment in Patients With Renal Tumors Undergoing Open, Laparoscopic and Nephron Sparing Surgery

et al. 2012

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Purpose We prospectively evaluated the general and cancer-specific quality of life (QOL) and psychosocial adjustment of patients with a renal mass who underwent radical versus partial nephrectomy performed by laparoscopic or open approaches. Materials and Methods 172 patients with renal tumors completed questionnaires before surgery and again at 3 weeks, 2, 3, 6, and 12 months post-surgery. We assessed general QOL (SF-36), cancer-specific-QOL (CARES-SF), intrusive thoughts and avoidance behaviors, and fear of recurrence. We used mixed model regression analyses to compare these measures across surgery types over the course of the study and adjusted for tumor size, histology, stage and renal function. Results The physical component score of the SF-36 different significantly by surgery type over time (p = 0.04). Patients who had laparoscopy improved by month 2 whereas those who had open surgery had poorer QOL until month 3. Better cancer-specific QOL was reported in patients undergoing radical versus partial nephrectomy. Age also had significant effects on outcomes. Conclusions We report on one of the most comprehensive patient-reported prospective QOL studies in RCC patients. There were significant differences in QOL and psychosocial adjustment outcomes over the course of one year among patients who had one of four commonly accepted surgical renal procedures, and we show that these outcomes must be evaluated in the context of tumor characteristics, cancer-specific outcomes and renal function. These QOL issues may be important to consider when choosing surgical procedures for patients with renal tumors.

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“…Minimally invasive techniques for extirpative renal surgery have emerged as a standard of care, oVering oncologic outcomes equivalent to open procedures while at the same time aVording the patient reduced recovery times and improved cosmesis [1][2][3][4][5][6][7][8][9][10]. However, these techniques are technically challenging, requiring considerable surgical skill and proper surgical planning.…”

Section: Introductionmentioning

confidence: 99%

Camera and trocar placement for robot-assisted radical and partial nephrectomy: which configuration provides optimal visualization and instrument mobility?

et al. 2009

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Proper camera and trocar placement is critical to the success of minimally invasive procedures. For robot-assisted renal surgery, two basic trocar configurations have been described. The medial approach, using a 30° downward-angled lens mimics a traditional transperitoneal laparoscopic configuration. An alternative configuration, using a 0° or 30° upward-angled lens approach locates the camera laterally, evoking a position sense similar to a retroperitoneal approach. Our objective is to compare the differences between these two standard approaches for robot-assisted renal surgery. After performing a review and analysis of available literature, our group tested both the medial and lateral camera approaches during robotic renal surgery performed in human patients. The medial approach provides a wide field of view, because of the relatively greater distance to the target structures and a horizon line closer to the patient's midline. The lateral configuration offers significantly different visualization. The relative proximity to the target structures and a higher horizon line results in a comparatively restricted field of vision. Instrument mobility is comparable between the two approaches. Meta-analysis of the literature reveals that both approaches provide comparable overall operative times for both radical and partial nephrectomy, though there is a trend towards shorter overall operative times for partial nephrectomy performed through a medial approach. The medial trocar configuration provides a familiar working environment for both surgeon and assistant; the wide-angle view enables enhanced visualization of surrounding structures and tracking of the instruments inserted by the assistant. The lateral approach offers the potential advantage of a closer view of the kidney, but does so at the expense of a significantly restricted field of view. In our experience, a medial trocar configuration offers significant advantages over the lateral trocar configuration, and is, therefore, the standard approach at our high-volume center.

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Health-related quality of life after hand-assisted laparoscopic and open radical nephrectomies of renal cell carcinoma

Abstract: The results showed that hand-assisted laparoscopic surgery is a minimally invasive surgical technique for RCC offering earlier recovery and similar long-term HRQOL compared with open surgery.

Cited by 13 publications

References 16 publications

Comparison of Magnetic Resonance Imaging and Contrast-Enhanced Ultrasound as Diagnostic Options for Unclear Cystic Renal Lesions: A Cost-Effectiveness Analysis

Comparison of Magnetic Resonance Imaging and Contrast-Enhanced Ultrasound as Diagnostic Options for Unclear Cystic Renal Lesions: A Cost-Effectiveness Analysis

Comprehensive Assessment of Quality of Life and Psychosocial Adjustment in Patients With Renal Tumors Undergoing Open, Laparoscopic and Nephron Sparing Surgery

Camera and trocar placement for robot-assisted radical and partial nephrectomy: which configuration provides optimal visualization and instrument mobility?

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