Predictive Factors of Renal Function in Partial Laparoscopic Nephrectomy in Patients with a Kidney Tumor

Romero, M.E. Jiménez; Moreno-Cortes, Jose C; Canelon-Castillo, Elba Y; Díez-Farto, Sara

doi:10.1159/000499277

Cited by 10 publications

(6 citation statements)

References 19 publications

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“…The study also reported that the greater the invasion of the surrounding structure, the greater the tumour Fuhrman Grade. 21 Similarly, our study reported ureteric involvement (13.8%), concurrent stones (15.3%) and cysts (5.6%) as well, which is reported at similar lower percentages in international studies. 22 Our study also compared the patients who had RFTs deterioration with those whose RFTs remained normal post-nephrectomy, and results revealed that the greater the Fuhrman Grade, the more will be chances of RFT deterioration (p=0.003).…”

Section: Discussionsupporting

confidence: 84%

Radical Nephrectomy for Renal Cell Carcinoma in a Tertiary Care Hospital in Islamabad

Roman

Habib²,

Alam³

2022

PAFMJ

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Objective: to identify the demographic, laboratory, radiological and histological features of RCC patients presenting to a tertiary care hospital in Islamabad. Study Design: Cross-sectional study. Place and Duration of Study: Pakistan Atomic Energy Commission General Hospital, Islamabad Pakistan, from Jan 2014 to Aug 2021. Methodology: All the patients who underwent radical nephrectomy for histologically confirmed RCC at PAEC General Hospital Islamabad were included in the study. Demographic variables, ultrasound features, laboratory measures, histological types and Fuhrman grading were noted. Results: A total of 65 consecutive patients were included, which included 38(58.5%) males. The mean age of the patients was 52.6±8.6 years. The most common symptom was flank pain (42.2%). The diagnosis was made incidentally in 26 patients. The most common ultrasound feature was capsule involvement (23, 35.3%), and most cases were Fuhrman Grade-II (22, 48.9%). On histology, clear cell carcinoma was the most common RCC (40, 61.5%). Post-operative early RFT deterioration was noted in 32(49.2%) patients. This was significantly associated with greater tumour size, Fuhrman Grade-III/IV, renal vein thrombosis, gerota fascia, and ureteric involvement. There was no mortality in our study during the admission days until discharge. Conclusion: Renal cell carcinoma was more common among males and at a later stage of life (5th decade). The most common type was clear cell carcinoma. Post-operative early RFT deterioration was noted in 49.2% of patients. It was associated with greater tumour size, Fuhrman Grade III and IV, renal vein thrombosis, gerota fascia, and ureteric involvement.

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Section: Discussionsupporting

confidence: 84%

Radical Nephrectomy for Renal Cell Carcinoma in a Tertiary Care Hospital in Islamabad

Roman

Habib²,

Alam³

2022

PAFMJ

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“…Previous reports have indicated that aging, diabetes, large tumors, heavy weight, longer WIT, longer surgery time, and high RENAL nephrometry scores influence renal function after partial nephrectomy [ 16 – 19 ]. Our study did not find a significant association between comorbidities, such as diabetes and postoperative renal function.…”

Section: Discussionmentioning

confidence: 99%

Predictive factors of renal function after robot-assisted partial nephrectomy in clinical T1b tumors

Yamamoto,

Numakura,

Kobayashi

et al. 2024

J Robotic Surg

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Robot-assisted partial nephrectomy (RAPN) has been shown to be a safe and effective method for treatment of small renal tumors, including clinical T1b renal cell carcinoma (RCC); however, the impact of RAPN for cT1b renal tumors on renal function is not well understood. In this retrospective study, 50 patients who underwent RAPN for cT1b renal tumors were evaluated for pre- and post-operative renal function and perioperative clinical factors. Renal function was assessed using the estimated glomerular filtration rate (eGFR) at baseline and on postoperative days (POD) 1, 7, 30, and 180.A significant renal functional decline was defined as ≥ 15% reduction in eGFR at POD180 compared with eGFR at baseline. Logistic regression analyses were used to identify risk factors for renal function decline, including age, sex, RENAL nephrometry score, operative time, and estimated blood loss. The median patient age was 62 years, and the median tumor diameter and RENAL nephrometry score were 44 mm (IQR 43–50) and 8 (IQR 7–9), respectively. Of these patients, 16 (36%) showed a significant renal functional decline at POD 180. In the multivariate analysis, the L component of the RENAL nephrometry score and an estimated blood loss of 200 mL or more were identified as significant risk factors for renal functional decline. These findings suggest that the preoperatively definable L component of the RENAL nephrometry score and intraoperative blood loss, which may be modifiable factors, play significant roles in post-RAPN renal function decline.

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“…(9) Este procedimento consiste em promover uma ressecção da massa renal com margens adequadas e tentar poupar o máximo possível de néfrons. Para obter uma correta extração do tumor, é possível isolar os vasos renais e pinçá-los (veia e artéria juntas ou pinçamento seletivo da artéria) para ressecção da massa sem sangramento (10). Martin et al estudaram os efeitos de diferentes formas de isquemia renal na função renal em pacientes submetidos à nefrectomia parcial minimamente invasiva.…”

Section: Discussionunclassified

Nefrectomia parcial sem isquemia é segura? Pontos sob a lesão controlam o sangramento em abordagem minimamente invasiva

De Oliveira,

Araujo,

Silva

et al. 2024

Braz. J. Hea. Rev.

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Introdução: A nefrectomia parcial é o tratamento padrão-ouro para pequenas massas renais. A extração e sutura do parênquima renal em apenas 20 minutos de isquemia tem sido uma limitação técnica na prática atual. Objetivo: Demonstrar uma nova técnica de nefrectomia parcial sem pinçamento do vaso utilizando pontos prévios sob o tumor, antes da ressecção. Método: Todos os procedimentos foram feitos por via laparoscópica. Os pontos com vicryl 2.0 foram feitos previamente à exérese do tumor após correta demarcação da lesão respeitando as margens livres. Resultados: O estudo contou com 19 pacientes submetidos à nefrectomia parcial. A média de idade foi de 58,26 anos. O tamanho do tumor variou de 1,6 a 4,0cm. A análise anatomopatológica confirmou: 13 tumores de células claras e os outros 3 eram oncocitomas, 1 papilífero tipo 1, 1 angiomiolipoma, 1 cisto. Apenas dois casos apresentaram margens escassas e todos os demais tiveram margens de ressecção livres. Conclusão: A nefrectomia parcial sem isquemia com pontos prévios sob a lesão é uma opção segura e viável em casos selecionados.

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Predictive Factors of Renal Function in Partial Laparoscopic Nephrectomy in Patients with a Kidney Tumor

Cited by 10 publications

References 19 publications

Radical Nephrectomy for Renal Cell Carcinoma in a Tertiary Care Hospital in Islamabad

Radical Nephrectomy for Renal Cell Carcinoma in a Tertiary Care Hospital in Islamabad

Predictive factors of renal function after robot-assisted partial nephrectomy in clinical T1b tumors

Nefrectomia parcial sem isquemia é segura? Pontos sob a lesão controlam o sangramento em abordagem minimamente invasiva

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