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https://www.readbyqxmd.com/read/29129269/partial-two-thirds-nephrectomy-in-pigs-a-comparison-of-three-surgical-approaches
#1
Hai-Feng Liu, Wei-Jing Meng, Xiang-Dong Kong, Ge Bai, Hui Li, Jian-Tao Zhang, Hong-Gang Fan, Hong-Bin Wang
Partial (2/3) nephrectomy can be performed via the laparoscopic, retroperitoneal, and transperitoneal approach. Outcomes of the three approaches were compared in this study. 2/3 nephrectomy were performed in 21 healthy Bama miniature pigs (mean bodyweight 20.59±2.78kg). Pigs were divided into three groups: those that underwent 2/3 nephrectomy via laparoscopy (LN group, n=7), the retroperitoneal approach (RN group, n=7), or the transperitoneal approach (TN group, n=7). We monitored pre- and postoperative physiologic parameters, blood cell count, and stress and renal function biomarkers...
November 7, 2017: Research in Veterinary Science
https://www.readbyqxmd.com/read/29118534/pure-retroperitoneoscopic-donor-nephrectomy-in-duplication-of-inferior-vena-cava-a-series-of-four-cases
#2
Bipin Chandra Pal, Pranjal R Modi, Syed Jamal Rizvi, Rohit Chauhan, Suresh Kumar, Shruti P Gandhi, Vivek B Kute, Hargovind L Trivedi
Aim: Complex vascular anatomy poses a major challenge to the donor surgeon. Here, we have described the technical nuances in retroperitoneoscopic living donor nephrectomy for the left kidney in the situations of a rare vascular anomaly of duplication of inferior vena. Materials and Methods: Between September 2005 and June 2016, 1460 retroperitoneoscopic living donor nephrectomy were carried out in single surgical unit of our institution. Out of these four donors were found to have duplication of inferior vena cava (IVC)...
October 2017: Urology Annals
https://www.readbyqxmd.com/read/29104784/external-validation-of-four-nephrometry-scores-for-trans-peritoneal-robotic-partial-nephrectomy
#3
Bhavan Prasad Rai, Amit Patel, Ahmed Abroaf, Narin Suleyman, Shanmugasundaram Gowriemohan, Venkat Prasad, Nikhil Vasdev, Jim Adshead
Introduction: External validation of four nephrometry scores (NS): Centrality index (C-index), arterial based complexity (ABC), preoperative aspects and dimensions used for an anatomical (PADUA) and radius expohytic/endophytic nearness anterior/posterior location (RENAL) scoring systems in patients who have undergone trans-peritoneal robotic assisted partial nephrectomy (RAPN). Material and methods: A prospective database for RAPN has been maintained. Individual NSs were performed on 3-dimensional reconstructions of MDCT/MRI studies retrospectively by a board certified uroradiologist...
2017: Central European Journal of Urology
https://www.readbyqxmd.com/read/29092632/comparison-of-kidney-function-in-the-early-postoperative-period-in-transperitoneal-robot-assisted-laparoscopic-partial-nephrectomy-between-anterior-and-posterior-renal-tumors-a-propensity-score-matched-study
#4
Toshio Takagi, Tsunenori Kondo, Kazuhiko Yoshida, Hirohito Kobayashi, Junpei Iizuka, Masayoshi Okumi, Hideki Ishida, Kazunari Tanabe
Objective To compare early postoperative renal function in transperitoneal robot assisted laparoscopic partial nephrectomy (RAPN) for anterior and posterior renal tumors. Patients and Methods This study included 227 patients who underwent transperitoneal RAPN for anterior or posterior renal tumors. Tumor position was defined by RENAL nephrometry score. To minimize selection bias between anterior and posterior tumors, patient variables were adjusted using 1:1 propensity score matching. Results Of the 227 patients, 125 were classified as having anterior tumors and 102 as having posterior tumors...
November 1, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/29078877/hydrogen-sulfide-prevents-renal-ischemia-reperfusion-injury-in-clawn-miniature-swine
#5
Mitsuhiro Sekijima, Hisashi Sahara, Katsuyuki Miki, Vincenzo Villani, Yuichi Ariyoshi, Takehiro Iwanaga, Yusuke Tomita, Kazuhiko Yamada
BACKGROUND: Hydrogen sulfide (H2S) has recently been reported to demonstrate both antiinflammatory and cytoprotective effects; however, its efficacy has not been well documented in large animal models. In this study, we examined whether the administration of H2S offers cytoprotective effects on renal ischemia-reperfusion injury (IRI) in a preclinical miniature swine model. METHODS: Major histocompatibility complex-inbred, CLAWN miniature swine (n = 9) underwent a right nephrectomy, followed by induction of a 120-min period of warm ischemia via placement of clamps on the left renal artery and vein...
November 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29074284/retroperitoneal-robot-assisted-versus-open-partial-nephrectomy-for-ct1-renal-tumors-a-matched-pair-comparison-of-perioperative-and-early-oncological-outcomes
#6
Marco Borghesi, Riccardo Schiavina, Francesco Chessa, Lorenzo Bianchi, Gaetano La Manna, Angelo Porreca, Eugenio Brunocilla
BACKGROUND: The objective of this study was to compare perioperative and early oncological outcomes of a matched cohort of patients who underwent retroperitoneal robot-assisted partial nephrectomy (RP-RAPN) and open partial nephrectomy (OPN) for clinically localized renal tumors. PATIENTS AND METHODS: We performed a retrospective analysis of patients who underwent RP-RAPN and OPN treated at 2 referral centers from January 2011 to December 2015. We focused on the following postoperative outcomes: warm ischemia time (WIT), operative time, blood loss, intra- and postoperative complications, estimated glomerular filtration rate (eGFR), hospital stay, and positive surgical margins...
October 3, 2017: Clinical Genitourinary Cancer
https://www.readbyqxmd.com/read/29048228/predictive-factors-for-achieving-superior-pentafecta-outcomes-following-robot-assisted-partial-nephrectomy-in-patients-with-localized-renal-cell-carcinoma
#7
Minyong Kang, In-Hyuck Gong, Hwi Jun Park, Hyun Hwan Sung, Hwang Gyun Jeon, Byong Chang Jeong, Seong Soo Jeon, Hyun Moo Lee, Han Yong Choi, Seong Il Seo
PURPOSE: To examine the perioperative outcomes following robot-assisted partial nephrectomy (RAPN) in patients with localized renal cell carcinoma (RCC) and to identify the predictors of Pentafecta achievement following RAPN. MATERIALS AND METHODS: We retrospectively analyzed the data from 362 patients with RCC who underwent RAPN from 2008 to 2016. The criteria for Pentafecta achievement was defined as the Trifecta [warm ischemia time (WIT) ≤ 25 minutes, negative surgical margin, and no significant perioperative complications]; with the addition of renal function preservation, including over 90% preservation of the estimated-glomerular filtration rate (e-GFR); and no stage upgrade of chronic kidney disease at 1 year after surgery...
October 19, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/29037183/robot-assisted-laparoscopic-reconstructed-management-of-multiple-aneurysms-in-renal-artery-primary-bifurcations-a-case-report-and-literature-review
#8
Hai-Bin Wei, Xiao-Long Qi, Feng Liu, Wang Jie, Xiao-Feng Ni, Qi Zhang, En-Hui Li, Xuan-Yu Chen, Da-Hong Zhang
BACKGROUND: Renal artery aneurysm (RAA) is rare and its incidence in the general population remains elusive. There have been few reports on the repair of multiple aneurysms conducted with the Da Vinci robot-assisted surgical platform (Intuitive Surgical Inc., Sunnyvale, CA, USA), especially for those located in renal artery primary bifurcations. CASE PRESENTATION: We report our experience in the surgical management of two expanding right-sided RAAs in a 64-year-old man using a robot-assisted laparoscopic approach...
October 16, 2017: BMC Urology
https://www.readbyqxmd.com/read/29023177/is-remote-ischemic-conditioning-of-benefit-to-patients-undergoing-kidney-transplantation
#9
Wisit Cheungpasitporn, Nadeen J Khoury, Charat Thongprayoon, Iasmina M Craici
Renal ischemia-reperfusion injury (IRI), an inevitable event during kidney transplantation procedure, can result in delayed graft function or even primary nonfunction. In addition to strategies to limit IRI such as advancements in organ allocation systems and preservation of organs, and reduction in cold and warm ischemia time, remote ischemic conditioning (RIC) has attracted much attention in recent years. With promising findings and data suggesting a potential benefit of RIC in animal kidney transplantation models, a few clinical trials have investigated the use of RIC in human kidney transplantation...
October 12, 2017: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/28985850/the-administration-of-argon-during-ex-vivo-normothermic-perfusion-in-an-experimental-model-of-kidney-ischemia-reperfusion-injury
#10
Stephanie F Smith, Thomas Adams, Sarah A Hosgood, Michael L Nicholson
BACKGROUND: Argon has shown potential as an organoprotective agent in numerous models of ischemia-reperfusion injury (IRI). The aim of this study was to evaluate the effects of argon gas during ex vivo normothermic perfusion (EVNP) in an experimental porcine model of kidney IRI. MATERIALS AND METHODS: After a warm ischemia time of 15 min and 17 h of static cold storage, porcine kidneys underwent 1 h of EVNP using leukocyte-depleted blood. During EVNP, kidneys were perfused with a gas composition either of 70% argon (n = 6), 70% nitrogen control (n = 6), or standard 95% oxygen (n = 6) balanced with 5% carbon dioxide...
October 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28975767/cd47-blockade-reduces-ischemia-reperfusion-injury-in-donation-after-cardiac-death-rat-kidney-transplantation
#11
Xuanchuan Wang, Min Xu, Jianluo Jia, Zhengyan Zhang, Joseph P Gaut, Gundumi A Upadhya, Pamela T Manning, Yiing Lin, William C Chapman
Modulation of nitric oxide (NO) activity through blockade of CD47 signaling has been shown to reduce ischemia-reperfusion injury (IRI) in various models of tissue ischemia. Here, we evaluate the potential effect of an antibody-mediated CD47 blockade in a syngeneic and an allogeneic DCD rat kidney transplant model. The donor organ was subjected to 1 hr of warm ischemia time after circulatory cessation, then flushed with a CD47 monoclonal antibody (CD47mAb) in the treatment group, or an isotype-matched immunoglobulin in the control group...
October 4, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28954531/is-off-clamp-always-beneficial-during-robotic-partial-nephrectomy-a-propensity-score-matched-comparison-of-clamp-technique-in-patients-with-two-kidneys
#12
Daniel C Rosen, David J Paulucci, Ronney Abaza, Daniel D Eun, Akshay Bhandari, Ashok K Hemal, Ketan K Badani
OBJECTIVE: The majority of patients undergoing partial nephrectomy (PN) present with a clinical T1a tumor with both kidneys present. Some groups have advocated using off-clamp (Off-C) techniques to eliminate warm ischemia whenever possible, even when elective. We evaluated whether Off-C technique during robotic PN (RPN) provides any functional benefit over main arterial clamping (MAC) in these patients. Subjects/Patients and Methods: A total of 351 patients with a R.E.N.A.L. nephrometry score (RNS) <10, T1a tumor, and two kidneys who underwent RPN from five high-volume surgeons between 2008 and 2016 were retrospectively identified from a multi-institutional database...
November 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28952698/-molecular-and-cellular-mechanisms-of-damage-to-renal-parenchyma-in-renal-warm-ischemia
#13
REVIEW
S V Popov, R G Guseinov, A G Martov, T M Muratov, N B Tabynbaev
Warm ischemia of the renal parenchyma is a forced feature of laparoscopic partial nephrectomy. It is accompanied by oxygen deprivation of the organ and followed by re-oxygenation, which can cause additional damage to the renal tissue. This damage can result in acute functional and structural disorders of individual parts of the nephron, increasing the risk for a renal dysfunction. Timely diagnosis of the dysfunction is vital for the success of the treatment. The article provides an overview of current scientific data on the mechanisms of ischemic and reperfusion injuries at the molecular-cellular level and describes the current methods of their detection...
September 2017: Urologii︠a︡
https://www.readbyqxmd.com/read/28932737/technical-intraoperative-maneuvers-for-the-management-of-inferior-vena-cava-thrombus-in-renal-cell-carcinoma
#14
Dionysios Dellaportas, Nikolaos Arkadopoulos, Ioannis Tzanoglou, Evgenios Bairamidis, George Gemenetzis, Pantelis Xanthakos, Constantinos Nastos, Georgia Kostopanagiotou, Ioannis Vassiliou, Vassilios Smyrniotis
INTRODUCTION: Renal vein or inferior vena cava (IVC) invasion by neoplastic thrombus in patients with renal cell carcinoma (RCC) is not an obstacle for radical oncological treatment. The aim of this study is to present our technical maneuvers for complete removal of the intracaval thrombus without compromising hemodymanic stability of the patient. MATERIALS AND METHODS: Between 2000 and 2014, 15 RCC patients with IVC involvement of levels I-III were treated with curative intent and were prospectively studied...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28923652/orthotopic-kidney-transplantation-in-the-rat-with-the-use-of-a-sleeve-arterial-anastomosis-method-and-a-modified-stenting-technique-for-renal-veins
#15
Z-D Jin, L-N Xue, L-S Peng
BACKGROUND: We describe a simple and reliable orthotopic kidney transplantation method in rats with the use of sleeve arterial anastomosis and a modified stenting technique for anastomosis of the renal vein (RV). METHODS: Male Fischer and Lewis rats were used as kidney donors and recipients, respectively, and their left kidneys were harvested in situ. In the control rats (n = 30), the renal artery (RA) and RV anastomoses were performed end-to-end with interrupted sutures by means of the conventional technique...
October 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28893213/application-and-analysis-of-retroperitoneal-laparoscopic-partial-nephrectomy-with-sequential-segmental-renal-artery-clamping-for-patients-with-multiple-renal-tumor-initial-experience
#16
Jundong Zhu, Fan Jiang, Pu Li, Pengfei Shao, Chao Liang, Aiming Xu, Chenkui Miao, Chao Qin, Zengjun Wang, Changjun Yin
BACKGROUND: To explore the feasibility and safety of retroperitoneal laparoscopic partial nephrectomy with sequential segmental renal artery clamping for the patients with multiple renal tumor of who have solitary kidney or contralateral kidney insufficiency. METHODS: Nine patients who have undergone retroperitoneal laparoscopic partial nephrectomy with sequential segmental renal artery clamping between October 2010 and January 2017 were retrospectively analyzed...
September 11, 2017: BMC Urology
https://www.readbyqxmd.com/read/28889600/normothermic-ex-vivo-kidney-perfusion-for-graft-quality-assessment-prior-to-transplantation
#17
J Moritz Kaths, Mátyás Hamar, Juan Echeverri, Ivan Linares, Peter Urbanellis, Jun Yu Cen, Sujani Ganesh, Luke S Dingwell, Paul Yip, Rohan John, Darius Bagli, Istvan Mucsi, Anand Ghanekar, David Grant, Lisa A Robinson, Markus Selzner
Normothermic ex vivo kidney perfusion (NEVKP) represents a novel approach for graft preservation and functional improvement in kidney transplantation. We investigated whether NEVKP also allows graft quality assessment before transplantation. Kidneys from 30-kg pigs were recovered in a model of heart-beating donation (group A) after 30 minutes (group B) or 60 minutes (group C) (n = 5/group) of warm ischemia. After 8 hours of NEVKP, contralateral kidneys were resected, grafts were autotransplanted, and the pigs were followed for 3 days...
September 10, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28875952/role-of-r-e-n-a-l-nephrometry-score-in-laparoscopic-partial-nephrectomy
#18
Hai-Jiang Zhou, Yong Yan, Jian-Zhong Zhang, Li-Rong Liang, Shu-Bin Guo
Background: Preoperative anatomical scoring system is conducive to comparison between treatment options and evaluation of postoperative outcomes in patients with small renal tumors. This study aimed to evaluate the clinical application efficacy of the R.E.N.A.L. nephrometry score (RNS) in predicting perioperative outcomes in patients with renal tumor who underwent laparoscopic partial nephrectomy (LPN). Methods: The clinical data of 139 patients with renal tumors who underwent LPN between 2009 and 2015 were collected and analyzed...
September 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28861728/off-clamp-robot-assisted-partial-nephrectomy-does-not-benefit-short-term-renal-function-a-matched-cohort-analysis
#19
Barrett G Anderson, Aaron M Potretzke, Kefu Du, Joel Vetter, R Sherburne Figenshau
In the interest of renal functional preservation, partial nephrectomy has supplanted radical nephrectomy as the preferred treatment for T1 renal masses. This procedure usually involves the induction of renal warm ischemia by clamping the hilar vessels prior to tumor excision. Performing robot-assisted partial nephrectomy (RAPN) "off-clamp" can theoretically prevent renal functional loss associated with warm ischemia. We describe our institutional experience and compare perioperative and renal functional outcomes using a propensity score matched cohort...
August 31, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28861703/robotic-assisted-vs-laparoscopic-donor-nephrectomy-a-retrospective-comparison-of-perioperative-course-and-postoperative-outcome-after-1-year
#20
Anthony Yang, Naman Barman, Edward Chin, Daniel Herron, Antonios Arvelakis, Dianne LaPointe Rudow, Sander S Florman, Michael A Palese
Safety is of utmost importance in live donor nephrectomies. In this study, we describe our initial experience with robot-assisted laparoscopic donor nephrectomy (RDN) in comparison with the standard laparoscopic donor nephrectomy (LDN). We retrospectively reviewed 95 patients who either underwent RDN or LDN performed by a single surgeon from 2011 to 2016 at a tertiary institution. Donor perioperative course and postoperative outcome along with recipient outcomes were compared. Of the 95 cases, 73 were classified as LDN and 22 were classified as RDN...
August 31, 2017: Journal of Robotic Surgery
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