Operative and oncological outcomes of salvage robotic radical and partial nephrectomy: a multicenter experience

Time trends in surgical provision and cancer-specific outcomes in patients with stage T2-3 kidney cancer: a SEER-based study

“…Nevertheless, PN is associated with an increased risk of complications and adverse side effects, as evidenced by several single-center retrospective analyses ( 34 – 36 ). Although one study had been challenged for population heterogeneity, subsequent adjustments and re-evaluations have reinforced the validity of these findings ( 37 , 38 ). By contrast, Jeldres and Peycelon have raised concerns for tumors classified as T2 stage and beyond, showing a 5.3-fold increase in the CSM risk associated with PN compared to RN ( 39 , 40 ).…”

Initial Experience with Hybrid Partial Nephrectomy with Ultrasound-guided Balloon Catheter Occlusion of the Renal Artery for Recurrent Renal Tumors

“…However, PN is much more difficult in the salvage setting in comparison to primary PN. The overall complication rate for repeat robotic or laparoscopic PN increased from 17.6% to 42% [4] , [6] , with the incidence of major complications (defined as Clavien-Dindo grade ≥III) as high as 10% [8] . One of the most common sPN complications was bleeding, with incidence ranging from 5.6% to 23% [4] and a blood transfusion rate of 5.9% [4] , [9] , [10] .…”

“…In addition, the difficulty in dissecting the renal hilum increased the rate of conversion to an off-clamp technique, which can lead to excessive bleeding during tumor resection [4] , [9] . Moreover, patients with recurrent renal cancer often already have impaired renal function [6] . Furthermore, the surgical margin may not be clear, which was more likely to lead to either greater resection of normal kidney tissue or inadequate resection of tumor, resulting in PSMs in 2.9–11.5% of cases [2] , [11] .…”

“…Robot-assisted PN (RAPN) presented as an effective and minimally invasive treatment option for recurrent renal cancers. However, difficulties in dissecting the renal hilum and other surrounding structures because of extensive abdominal adhesions greatly increase the risk of complications and the positive surgical margin (PSM) rate in salvage PN (sPN), in comparison to the initial surgery [4] , [5] , [6] . Therefore, a conventional sPN approach significantly affects the achievement of trifecta outcomes, including complete removal of the tumor, maximum preservation of renal function, and surgical safety.…”

Redo Partial Nephrectomy for Local Recurrence After Previous Nephron-sparing Surgery. Surgical Insights and Oncologic Results from a High-volume Robotic Center

“…In this context, the role of redo PN for recurrent RCC is still overlooked. Only few studies explored the effects of either PN or radical nephrectomy (RN) on survival outcomes after previous local therapy for RCC [6] , [7] , [8] , [9] . As such, it is still controversial whether PN may represent a safe and effective treatment option as compared with RN also in the redo renal surgery setting.…”