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Partial nephrectomy

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https://www.readbyqxmd.com/read/28822586/intravenous-mannitol-versus-placebo-during-partial-nephrectomy-in-patients-with-normal-kidney-function-a-double-blind-clinically-integrated-randomized-trial
#1
Massimiliano Spaliviero, Nicholas E Power, Katie S Murray, Daniel D Sjoberg, Nicole E Benfante, Melanie L Bernstein, James Wren, Paul Russo, Jonathan A Coleman
BACKGROUND: Mannitol is currently used as a renal protective agent to mitigate the effects of renal ischemia during nephron-sparing surgery (NSS). This routine practice lacks rigorous methodological study. OBJECTIVE: To assess the effect on renal function outcomes after surgery of mannitol infusion prior to renal ischemia during NSS. DESIGN, SETTING, PARTICIPANTS: This prospective, randomized, placebo-controlled, double-blind trial included 199 patients with a preoperative estimated glomerular filtration rate (eGFR) >45ml/min/1...
August 16, 2017: European Urology
https://www.readbyqxmd.com/read/28818550/perinephric-and-sinus-fat-invasion-in-stage-pt3a-tumors-managed-by-partial-nephrectomy
#2
Pascal Mouracade, Julien Dagenais, Jaya Sai Chavali, Onder Kara, Ryan J Nelson, Matthew J Maurice, Jeremy Reese, Brian I Rini, Jihad H Kaouk
INTRODUCTION: We evaluated the influence of perinephric fat invasion (PFI) compared with sinus fat invasion (SFI) on disease-free survival (DFS) and cancer-specific survival (CSS) after partial nephrectomy (PN) for stage pT3a renal cell carcinoma (RCC). MATERIALS AND METHODS: Data were recorded from the consecutive records of patients who had undergone underwent PN for cT1-T2 RCC from 2007 to 2016. Of these patients, 143 had stage pT3a with SFI or PFI found on final pathologic examination...
July 26, 2017: Clinical Genitourinary Cancer
https://www.readbyqxmd.com/read/28816275/-clinical-application-of-retroperitoneal-laparoscopic-surgery-combined-with-mini-flank-incision-hybrid-surgery-for-partial-nephrectomy-of-complex-renal-tumors
#3
X J Ye, J Liu, A Ablimit, L L Xiong, S J Liu, T Xu, X B Huang
OBJECTIVE: To evaluate the clinical effect and safety of retroperitoneal laparoscopic surgery combined with mini-flank incision "hybrid surgery" for partial nephrectomy of complex renal tumors. METHODS: Between April 2015 and December 2016, the clinical data from 16 patients with complex renal tumors who underwent the "hybrid surgery", including 10 males and 6 females, were retrospectively reviewed. The average age was (50.2±10.7) years, 9 cases were located in the left side and 7 cases in the right side, the mean tumor size was (6...
August 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28816274/-retroperitoneal-laparoscopic-with-renal-pedicle-rotation-for-partial-nephrectomy-of-ventro-renal-tumor
#4
Y H Liang, X B Zu, X Cheng, L F Liu
OBJECTIVE: Retro-laparoscopic partial nephrectomy is a challenge for ventro-renal tumors, especially hilar tumors. The tumors are partial or entirely out of operative field and there is blind space for operation. To solve this problem, a set of techniques including renal pedicle rotation is developed. METHODS: A set of techniques including renal pedicle rotation, double-layer suture, early artery unclamping for retro-laparoscopic nephrectomy for ventro-renal tumors, especially hilar tumors were developed...
August 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28803678/laparoscopic-partial-nephrectomy-with-prior-superselective-embolisation-as-treatment-for-giant-renal-angiomyolipoma
#5
A Husillos Alonso, D Subirá Ríos, E Bolufer Moragues, I Lopez Díez, I Moncada Iribarren, C González Enguita
OBJECTIVE: Cases of giant renal angiomyolipoma (>9cm) are a therapeutic challenge due to their low frequency and large size. The treatment objective for patients with renal angiomyolipoma should be complete tumour extirpation, with a nephron-sparing surgical technique, without complications and using a minimally invasive approach. MATERIAL AND METHODS: We present 3 cases of giant angiomyolipoma (10 12 and 14cm) treated with a combined approach: superselective embolisation and subsequent laparoscopic partial nephrectomy, in 3 separate hospitals...
August 10, 2017: Actas Urologicas Españolas
https://www.readbyqxmd.com/read/28802596/effects-of-differential-phase-remote-ischemic-preconditioning-intervention-in-laparoscopic-partial-nephrectomy-a-single-blinded-randomized-controlled-trial-in-a-parallel-group-design
#6
Yuan-Yuan Hou, Yun Li, Shu-Fang He, Jie Song, De-Xin Yu, Gordon T C Wong, Ye Zhang
STUDY OBJECTIVE: There are two windows of protection for remote ischemic preconditioning (RIPC), an early (ERIPC) and a late-phase (LRIPC). While ERIPC has been well studied, works on LRIPC are relatively scarce, especially for the kidneys. We aimed to compare the effects of early-phase versus late-phase RIPC in patients with laparoscopic partial nephrectomy (LPN). DESIGN: A randomized controlled study SETTING: The Second Affiliated Hospital of Anhui Medical University, 1 May 2012 to 30 October 2013 PATIENTS: Sixty-five ASA 1 to 2 patients scheduled for LPN were located randomly to ERIPC group, LRIPC group and CON group (control)...
September 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28801217/evaluation-of-unplanned-hospital-readmissions-after-major-urologic-inpatient-surgery-in-the-era-of-accountable-care
#7
Benjamin V Stone, Matthew R Cohn, Nicholas M Donin, Michael Schulster, James S Wysock, Danil V Makarov, Marc A Bjurlin
OBJECTIVE: To provide a multi-institutional analysis of clinical factors predicting unplanned hospital readmission after major inpatient urologic surgery. MATERIALS AND METHODS: The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) is a risk-adjusted data collection mechanism for analyzing clinical outcomes data including 30-day perioperative readmissions and complications. We identified 23,108 patients who underwent major inpatient urologic surgery from 2011 to 2012...
August 8, 2017: Urology
https://www.readbyqxmd.com/read/28799884/differences-in-renal-tumor-size-measurements-for-computed-tomography-versus-magnetic-resonance-imaging-implications-for-patients-on-active-surveillance
#8
Irtaza Khan, Alp Tuna Beksac, David J Paulucci, Ronney Abaza, Daniel D Eun, Akshay Bhandari, Ketan K Badani
PURPOSE: To evaluate and compare the accuracy of computed tomography (CT) and magnetic resonance imaging (MRI) in predicting the final pathologic tumor size of partial nephrectomy specimens. MATERIALS AND METHODS: We analyzed a multi-institutional database of 807 patients who underwent robotic partial nephrectomy for a cT1a renal mass from 2006 to 2016. Patients who had a solitary tumor with complete data on the baseline imaging modality and the tumor size (baseline and pathologic) (n = 349) were included for analysis...
August 11, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28799022/early-vs-standard-unclamping-technique-in-minimal-access-partial-nephrectomy-a-meta-analysis-of-observational-cohort-studies-and-the-lister-cohort
#9
REVIEW
Thomas Stonier, Bhavan Prasad Rai, Mariele Trimboli, Ahmed Abroaf, Amit Patel, S Gowrie-Mohan, Venkat Prasad, Nikhil Vasdev, Jim Adshead
To evaluate if early unclamping (EUC) of the renal pedicle compromises perioperative outcomes in minimally invasive partial nephrectomy (PN). The cohort study includes all robot-assisted PN performed between September 2012 and September 2015 by a single surgeon at the Lister Hospital, Stevenage, UK. The systematic review and meta-analysis was performed according to the PRISMA guidelines identifying studies comparing EUC and standard unclamping (SUC) in either laparoscopic or robot-assisted PN. The Lister cohort prospectively reported 84 cases of robot-assisted PN (SUC = 22, EUC = 62) with a mean age of 58 years (SD = 11)...
August 10, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28798821/benchmarking-quality-for-renal-cancer-surgery-canadian-kidney-cancer-information-system-ckcis-perspective
#10
Keith A Lawson, Olli Saarela, Zhihui Liu, Luke T Lavallée, Rodney H Breau, Lori Wood, Michael A S Jewett, Anil Kapoor, Simon Tanguay, Ronald B Moore, Ricardo Rendon, Frederic Pouliot, Peter C Black, Jun Kawakami, Darrel Drachenberg, Antonio Finelli
INTRODUCTION: There is a lack of validated quality metrics to evaluate the care of patients receiving surgery for renal cell carcinoma (RCC). To address this, the Kidney Cancer Research Network of Canada defined a list of quality indicators (QI) to assess hospital-level performance. We have case-mix adjusted these QIs to benchmark RCC surgical care at Canadian academic centres. METHODS: The Canadian Kidney Cancer information system (CKCis) was used to measure six QIs: laparoscopic approach proportion (LA), partial nephrectomy proportion (PN), partial nephrectomy in patients with chronic kidney disease (CKDPN), positive margin rate (PMR), partial nephrectomy complication rate (PNCx), and warm ischemia time (WIT)...
August 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/28797586/obesity-as-defined-by-waist-circumference-but-not-body-mass-index-is-associated-with-higher-renal-mass-complexity
#11
Laura A Bertrand, Lewis J Thomas, Peng Li, Claire M Buchta, Shannon K Boi, Rachael M Orlandella, James A Brown, Kenneth G Nepple, Lyse A Norian
OBJECTIVES: Obesity, typically defined as a body mass index (BMI)≥30kg/m(2), is an established risk factor for renal cell carcinoma (RCC) but is paradoxically linked to less advanced disease at diagnosis and improved outcomes. However, BMI has inherent flaws, and alternate obesity-defining metrics that emphasize abdominal fat are available. We investigated 3 obesity-defining metrics, to better examine the associations of abdominal fat vs. generalized obesity with renal tumor stage, grade, or R...
August 7, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28795993/results-of-the-first-prospective-multi-institutional-treatment-study-in-children-with-bilateral-wilms-tumor-aren0534-a-report-from-the-children-s-oncology-group
#12
Peter Ehrlich, Yuen Y Chi, Murali M Chintagumpala, Fred A Hoffer, Elizabeth J Perlman, John A Kalapurakal, Ann Warwick, Robert C Shamberger, Geetika Khanna, Tom E Hamilton, Ken W Gow, Arnold C Paulino, Eric J Gratias, Elizabeth A Mullen, James I Geller, Paul E Grundy, Conrad V Fernandez, Michael L Ritchey, James S Dome
OBJECTIVE: The Children's Oncology Group study AREN0534 aimed to improve event-free survival (EFS) and overall survival (OS) while preserving renal tissue by intensifying preoperative chemotherapy, completing definitive surgery by 12 weeks from diagnosis, and modifying postoperative chemotherapy based on histologic response. BACKGROUND: No prospective therapeutic clinic trials in children with bilateral Wilms tumors (BWT) exist. Historical outcomes for this group were poor and often involved prolonged chemotherapy; on NWTS-5, 4-year EFS for all children with BWT was 56%...
September 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28794599/beware-a-simple-renal-cyst-could-be-a-hydatid-cyst
#13
Nidhi Sehgal, Vinod Priyadarshi
Kidney is one of the most common sites for the cyst formation in the body, and the management of simple cysts is required entirely for its symptoms and complications. Surgical decortication is an established treatment for a large and symptomatic simple renal cyst. On the other hand, hydatid cysts of the kidney are usually multiloculated complex or calcified cysts and are quite rare. Their surgical treatment also differs and requires complete excision with pericystectomy or partial/complete nephrectomy depending upon residual functional parenchyma, using extreme caution to avoid spillage, recurrence or development of severe anaphylactic shock...
July 2017: Urology Annals
https://www.readbyqxmd.com/read/28794588/renal-cell-carcinomas-mass-of-4-cm-are-not-always-indolent
#14
Nessn H Azawi, Lars Lund, Mikkel Fode
CONTEXT: The rate of progression to metastatic disease in patients undergoing active surveillance for small renal tumors varies in the literature between 1% and 8%. AIMS: This study aims to examine the incidence of metastasis in small renal tumors of <4 cm in a Danish cohort. SETTINGS AND DESIGN: Retrospective. MATERIALS AND METHODS: Data on 106 patients who were diagnosed with renal cancer (RCC) of <4 cm by CT scan from January 2005 to December 2013 were collected retrospectively in January 2016 from patient charts and analyzed...
July 2017: Urology Annals
https://www.readbyqxmd.com/read/28792194/laparoscopic-partial-nephrectomy-for-tumors-7cm-and-above-perioperative-outcomes
#15
Matvey Tsivian, Efrat Tsivian, Yury Stanevsky, Roman Bass, A Ami Sidi, Alexander Tsivian
PURPOSE: To assess and report the outcomes of laparoscopic partial nephrectomy )LPN) for T2 renal masses. MATERIALS AND METHODS: Retrospective review of patients undergoing LPN for clinically localized renal masses ≥7cm between the years 2005-2016. Descriptive analyses were generated for demographics, lesion characteristics, perioperative variables (operative time, warm ischemia time (WIT), estimated blood loss (EBL), intra-operative and post-operative complications (IOC and POC) and pathologic variables (pathology, subtype and Fuhrman grade)...
August 8, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/28792193/partial-nephrectomy-for-t3an0m0-renal-cell-carcinoma-shall-we-step-forward
#16
Ding Peng, Zhi-Song He, Xue-Song Li, Qi Tang, Lei Zhang, Kai-Wei Yang, Xiao-Teng Yu, Cui-Jian Zhang, Li-Qun Zhou
OBJECTIVES: To evaluate the prognosis of non-metastatic T3a renal cell carcinoma (RCC) with partial nephrectomy (PN). PATIENTS AND METHODS: We retrospectively evaluated 125 patients with non-metastatic T3a RCC. Patients undergoing PN and radical nephrectomy (RN) were strictly matched by clinic-pathologic characteristics. Log-rank test and Cox regression model were used for univariate and multivariate analysis. RESULTS: 18 pair patients were matched and the median follow-up was 35...
August 8, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/28791497/low-preoperative-serum-cholesterol-level-is-associated-with-aggressive-pathologic-features-and-poor-cancer-specific-survival-in-patients-with-surgically-treated-renal-cell-carcinoma
#17
Ho Won Kang, Sung Pil Seo, Won Tae Kim, Seok Joong Yun, Sang-Cheol Lee, Wun-Jae Kim, Eu Chang Hwang, Seok Ho Kang, Sung-Hoo Hong, Jinsoo Chung, Tae Gyun Kwon, Hyeon Hoe Kim, Cheol Kwak, Seok-Soo Byun, Yong-June Kim
BACKGROUND: The prognostic implications of preoperative serum total cholesterol (TC) level in patients with renal cell carcinoma (RCC) remain poorly understood. We investigated the prognostic role of preoperative serum TC in patients with surgically treated RCC from a large, multi-institutional Korean collaboration. PATIENTS AND METHODS: A database of 3064 patients with RCC who underwent radical or partial nephrectomy between 1999 and 2011 at eight academic centers was analyzed...
August 8, 2017: International Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28789928/engaging-patients-in-complex-clinical-decision-making-successes-pitfalls-and-future-directions
#18
REVIEW
Aaron A Laviana, Stephanie C Pannell, Kathy H Y Huen, Jonathan Bergman
BACKGROUND: By 2022, there will be 18 million predicted cancer survivors, which is an estimated 30% more than the number of survivors in 2012. In prostate cancer alone, the most common cancer in American men other than skin cancer, 1 in 7 men will be diagnosed during their lifetime. Nevertheless, only approximately 1 in 39 will actually die of the disease. Although life expectancy is often good, these men have multiple treatment management options to choose from, including active surveillance, surgery, or radiotherapy, each of which carries its own array of long-term adverse effects...
August 5, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28781110/association-of-race-and-margin-status-among-patients-undergoing-robotic-partial-nephrectomy-for-t1-renal-cell-carcinoma-results-from-a-population-based-cohort
#19
Victor S Chen, Robert Abouassaly, Christopher M Gonzalez, Alexander Kutikov, Marc C Smaldone, Neal J Meropol, Sarah P Psutka, Stephen B Williams, Rebecca O'Malley, Hillary M Sedlacek, Simon P Kim
OBJECTIVE: To assess the relationship of race and margin status among patients undergoing robotic partial nephrectomy (RPN) for T1 renal tumors from a contemporary population-based cohort. METHODS: Using the National Cancer Database, we identified patients with localized renal cell carcinoma (RCC) (clinical T1N0M0) who underwent RPN from 2010 to 2013. The primary outcome was positive surgical margins (PSM). Multivariable logistic regression analyses were used to assess the association between race and PSM adjusting for patient clinicopathologic and hospital factors...
August 3, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28767801/predictors-of-mortality-in-patients-submitted-to-nephrectomy-for-non-metastatic-renal-cell-carcinoma-at-a-referral-center-in-northeastern-brazil
#20
Marcus Vinicius Silva Araújo Gurgel, Josualdo Alves, Guilherme Bruno Fontes Vieira, Felipe de Castro Dantas Sales, Marcos Venício Alves Lima
Objective: to identify predictors of mortality in patients submitted to nephrectomy for non-metastatic renal cancer. Methods: we conducted a retrospective cohort study based on the records of patients with renal cancer submitted to radical or partial nephrectomy at the Ceará Cancer Institute. Results: we studied 117 patients, with mean and median age of 59.14 and 59 years, respectively. The male gender was slightly predominant. The right kidney was most frequently affected (64%)...
May 2017: Revista do Colégio Brasileiro de Cirurgiões
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