Nephron-Sparing Surgery for Renal Tumours: Acceleration and Facilitation of the Laparoscopic Technique

Häcker, Axel; Albadour, Ansad; Jauker, Werner; Ziegerhofer, Josef; Albquami, N.; Jeschke, Stephan; Leeb, Karl; Janetschek, Guenter

doi:10.1016/j.eururo.2006.07.025

Cited by 58 publications

(44 citation statements)

References 16 publications

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“…Mean tumor size and mean warm ischemia time were 35+/-12 mm and 20.1+/-7 minutes, respectively. These were comparable with previous studies (4,5,17). Previous studies described an association between the depth of tumor invasion and rate of hemorrhage.…”

Section: Discussionsupporting

confidence: 82%

“…Therefore, a combination of different hemostasis methods has been investigated (17). In a previous study the authors compared seven hemostatic agents in an animal partial nephrectomy model (17). The authors concluded that hemostatic agents were effective for small vascular injuries.…”

Section: Discussionmentioning

confidence: 99%

“…Fibrin sealants were reported as easy to use but not effective in dealing with major vascular injury. Therefore, a combination of different hemostasis methods has been investigated (17). In a previous study the authors compared seven hemostatic agents in an animal partial nephrectomy model (17).…”

Section: Discussionmentioning

confidence: 99%

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Bleeding during laparoscopic partial nephrectomy: Can a hemostatic matrix help to improve hemostasis?

Özgör

Şimşek

Aydoğdu

et al. 2016

Arch Ital Urol Androl

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

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Bleeding during laparoscopic partial nephrectomy: Can a hemostatic matrix help to improve hemostasis?

Özgör

Şimşek

Aydoğdu

et al. 2016

Arch Ital Urol Androl

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“…In one case, there was severe renal edema without identification of renal pelvis and the patient underwent nephrectomy. DISCUSSION UL is a major postoperative complication of PN, with a reported incidence of 0%-33% (1,(4)(5)(6)(8)(9)(10)(11)(12)(13)(14)(15) (Table 3). In this study, we evaluated the incidence; risk factors and management of UL encountered following PNs performed in a single tertiary medical center.…”

Section: Resultsmentioning

confidence: 99%

“…However, PN remains a technically challenging procedure, associated with increased risk of perioperative complications, including bleeding and urinary leakage (UL) (4). UL is considered as one of the most common perioperative complications of PN, with an estimated incidence ranging between 0% and 33% (3,(5)(6)(7)(8)(9)(10). Conservative measures such as catheter drainage, ureteral stenting, or percutaneous nephrostomy (PCN) placement, generally resolve the UL.…”

Section: Introductionmentioning

confidence: 99%

Postoperative Urinary Leakage Following Partial Nephrectomy for Renal Mass: Risk Factors and a Proposed Algorithm for the Diagnosis and Management

et al. 2016

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Objectives: to evaluate the current incidence, risk factors, management, and long-term follow-up of urinary leakage following partial nephrectomy, in order to propose an algorithm for diagnosis and evaluation of postoperative urinary leakage.Materials and Methods: the study included 752 patients who underwent elective partial nephrectomies for renal masses between the years 1988 and 2013. Patients' demographics, clinico-pathologic variables, and operative details were collected retrospectively. the associations between urinary leakage and patients' variables were assessed by univariate and multivariate analyses.Results: of the 752 patients, 21 (2.8%) experienced urinary leakage; 4 of the 21 patients with urinary leakage had spontaneous resolution, 1 patient underwent nephrectomy, and 16 patients were treated by retrograde ureteral stents insertion. one of them necessitated insertion of an additional percutaneous nephrostomy and another one deserved concomitant percutaneous drainage of a perirenal urinoma. the average period of time that elapsed from the operation until the insertion of stent was 8.5 ± 4.5 days. stents were removed 68 ± 20.5 days postoperatively. none of the patients had either persistent or repeated leakage. on univariate analysis, hilar renal masses (p < 0.04) and higher preoperative creatinine levels (p < 0.01) were found to be associated with higher rates of urinary leakage. none of these variables was significant on a multivariate analysis. review of the urinary leakage rate over time revealed it has been constantly decreasing over time, from 4% in early cases to 1.3% among the most recent ones.Conclusion: none of the preoperative variables that were examined in this study was significantly associated with increased risk of urinary leakage. however, cumulative *T. Erlich and Y. Abu-Ghanem contributed equally to the writing of this article. Original Research Article T. Erlich, et al. 140 surgical experience was associated with lower rates of urinary leakage, suggesting that the decrease in its incidence is related to the improved surgical skills, rather than to differences in tumors' or patients' characteristics.

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Anatomical Relationship Between the Kidney Collecting System and the Intrarenal Arteries in the Sheep: Contribution for a New Urological Model

Buys-Gonçalves¹,

Souza²,

Sampaio³

et al. 2016

The Anatomical Record

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Previous studies have demonstrated that the pig collecting system heals after partial nephrectomy without closure. Recently, a study in sheep showed that partial nephrectomy without closure of the collecting system resulted in urinary leakage and urinoma. The aim of this study was to present detailed anatomical findings on the intrarenal anatomy of the sheep. Forty two kidneys were used to produce tridimensional endocasts of the collecting system together with the intrarenal arteries. A renal pelvis which displayed 11-19 (mean of 16) renal recesses was present. There were no calices present. The renal artery was singular in each kidney and gave two primary branches one to the dorsal surface and one to ventral surface. Dorsal and ventral branches of the renal artery were classified based on the relationship between their branching pattern and the collecting system as: type I (cranial and caudal segmental arteries), type II (cranial, middle and caudal segmental arteries) or type III (cranial, cranial middle, caudal middle, and caudal segmental arteries). Type I was the most common branching pattern for the dorsal and ventral branches of the renal artery. The arterial supply of the caudal pole of the sheep kidney supports its use as an experimental model due to the similarity to the human kidney. However, the lack of a retropelvic artery discourages the use of the cranial pole in experiments in which the arteries are an important aspect to be considered. Anat Rec, 299:405-411, 2016. V C 2016 Wiley Periodicals, Inc.

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Nephron-Sparing Surgery for Renal Tumours: Acceleration and Facilitation of the Laparoscopic Technique

Cited by 58 publications

References 16 publications

Bleeding during laparoscopic partial nephrectomy: Can a hemostatic matrix help to improve hemostasis?

Bleeding during laparoscopic partial nephrectomy: Can a hemostatic matrix help to improve hemostasis?

Postoperative Urinary Leakage Following Partial Nephrectomy for Renal Mass: Risk Factors and a Proposed Algorithm for the Diagnosis and Management

Anatomical Relationship Between the Kidney Collecting System and the Intrarenal Arteries in the Sheep: Contribution for a New Urological Model

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