Robotic Partial Nephrectomy Without Renal Ischemia

Novak, R; Mulligan, Daniel; Abaza, Ronney

doi:10.1016/j.urology.2012.01.065

Cited by 43 publications

(27 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In another study, it has been indicated that RPN without ischemia is a feasible method in patients with a solitary tumor or with multiple tumors in one kidney, which therefore, necessitates a longer ischemia period. [22] Similar to our study, in this study conducted on a total of twenty-two patients, although immediate postoperative eGFR values decreased in relative to the preoperative period, it was observed that the values assessed at the 6 th postoperative month were the same with the preoperative values. For eleven patients in the off-clamp group in our study, our most important preference criteria for performing this method was that the tumor was mostly exophytically located.…”

Section: Discussionsupporting

confidence: 86%

Impact of robotic partial nephrectomy with and without ischemia on renal functions: experience in 34 cases

Ener

Canda

Altinova

et al. 2016

Turkish Journal of Urology

View full text Add to dashboard Cite

Objective: In this study we aimed to compare renal functions in patients who underwent robotic partial nephrectomy (RPN) with on-clamp and zero-ischemia techniques. Material and methods:Between 2009 and 2015, 12 off-clamp and 22 on-clamp RPN procedures were performed on a total of 34 patients in two centers. The main outcome parameters examined were serum creatinine, and estimated glomerular filtration rate (eGFR) during preoperative, immediate postoperative periods, and at postoperative 3 rd months.Results: There were no statistically significant differences between on-clamp and zero-ischemia groups regarding age, ASA score, BMI, PADUA and R.E.N.A.L. nephrometry scores, operation time and tumor size (p>0.05). Significant differences were found in the duration of hospital stay (3.8±0.9 days vs. 3.0±0.9 days) and amount of blood loss (85.9±49.6 mL vs. 183.3±176.2 mL) between the on-clamp and zero-ischemia groups (p<0.05). Statistically significant differences were found between preoperative and immediate postoperative periods, in terms of eGFR and serum creatinine levels in both groups. Moreover, statistically significant differences were found between preoperative and postoperative 3 rd month periods, in the on-clamp group in terms of eGFR and serum creatinine levels. In the zero-ischemia group, the decrease in eGFR and serum creatinine levels at postoperative 3 rd month relative to the preoperative period was not statistically significant. Conclusion:Off-clamp RPN technique is superior, in short-term outcomes involving renal functions, compared to on clamp approach. However, long-term data regarding the renal functions should be evaluated to arrive at a definitive decision.

show abstract

Section: Discussionsupporting

confidence: 86%

Impact of robotic partial nephrectomy with and without ischemia on renal functions: experience in 34 cases

Ener

Canda

Altinova

et al. 2016

Turkish Journal of Urology

View full text Add to dashboard Cite

show abstract

“…For localized HRM, partial nephrectomy is widely accepted as a standard therapy. Additionally, roboticassisted partial nephrectomy has recently become an alternative to standard laparoscopy, with the advantages of more technologically advanced instrumentation, 7 providing good surgical vision by three-dimension, and accurate mobility for suturing.…”

Section: Discussionmentioning

confidence: 99%

Ureteropelvic junction obstruction and renal cell carcinoma in a patient with solitary functioning kidney

Jeong

Park

et al. 2016

CUAJ

View full text Add to dashboard Cite

show abstract

“…Ng and colleagues proposed a combination of pharmacologically induced hypotension of the kidney in combination with micro-dissection and super selective clamping of renal artery branches [12]. Furthermore, there is a preliminary series of robotic zero ischemia partial nephrectomies [26] and laparoscopic off-clamp nephron-sparing surgery even for hilar renal masses [13,14]. The feasibility and the benefit of open nephron-sparing surgery in zero ischemia have been well proven in general [16].…”

Section: Discussionmentioning

confidence: 99%

ZIRK-Technique: Zero Ischemia Resection in the Kidney for High-Risk Renal Masses: Perioperative Outcome

Kriegmair¹,

Pfalzgraf²,

Häcker³

et al. 2015

Urol Int

View full text Add to dashboard Cite

Objectives: This study evaluates the feasibility and safety of open-partial nephrectomies in the ZIRK-technique (Zero Ischemia Resection in the Kidney) for renal masses with high-risk anatomical features - objectified by the PADUA score. Methods: We identified 40 consecutive cases of partial nephrectomies performed without clamping of the renal artery in our department of urology. Retrospective analysis of the preoperative CT or MRI scans showed 27 cases with a PADUA score ≥8, of which 15 cases had a score ≥10. Cases were in particular assessed regarding operation time (ORT), estimated blood loss (EBL), surgical margins and postoperative complications using the Clavien classification. Results: The mean age of the study population was 67.6 years with an average BMI of 26.8 kg/m². The mean ORT was 1:46 with an average EBL of 521 ml. Clavien grade II complications were observed seven times, while 3 patients had a grade IIIa complication. Despite complex and adverse location of the tumors, nephron-sparing surgery without ischemia could be performed with negative surgical margins for all cases. EBL, transfusion rate and complication were considerably more frequent in high-risk tumors. Conclusion: Highly complex renal tumors, PADUA ≥10, can be resected in ZIRK-technique with good operative outcome and a low complication rate.

show abstract

Robotic Partial Nephrectomy Without Renal Ischemia

Cited by 43 publications

References 25 publications

Impact of robotic partial nephrectomy with and without ischemia on renal functions: experience in 34 cases

Impact of robotic partial nephrectomy with and without ischemia on renal functions: experience in 34 cases

Ureteropelvic junction obstruction and renal cell carcinoma in a patient with solitary functioning kidney

ZIRK-Technique: Zero Ischemia Resection in the Kidney for High-Risk Renal Masses: Perioperative Outcome

Contact Info

Product

Resources

About