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renal warm ischemia

Jianfei Ye, Shudong Zhang, Xiaojun Tian, Guoliang Wang, Lei Zhao, Lulin Ma
Objective Laparoscopic knot-tying and suturing are the most difficult steps in shortening the warm ischemia time and learning curve of laparoscopic nephron-sparing surgery. This study was performed to demonstrate the safety, oncological efficacy, and technical tips of sutureless retroperitoneal laparoscopic nephron-sparing surgery (RPNSS). Methods This retrospective study included 78 cases of RPNSS using a sutureless technique and 126 cases of RPNSS using a single-layer barbed self-retaining suture technique performed from December 2012 to December 2016...
January 1, 2018: Journal of International Medical Research
José A Damasceno-Ferreira, Leonardo A S Abreu, Gustavo R Bechara, Waldemar S Costa, Marco A Pereira-Sampaio, Francisco J B Sampaio, Diogo B De Souza
BACKGROUND: Mannitol has been employed to ameliorate renal warm ischemia damage during partial nephrectomy, however, there is limited scientific evidence to support the use of mannitol during partial nephrectomy. The objective of the present study was to investigate the glomerular number after renal warm ischemia, with and without the use of mannitol in a Pig Model. METHODS: Twenty-four male pigs were assigned into three groups. Eight animals were allocated to the sham group that was subjected to laparoscopic dissection of the left renal hilum, without renal ischemia...
March 6, 2018: BMC Urology
Yan-Na Liu, Li-Xin Yu, Wen-Feng Deng, Kai-Qun Li, Ru-Min Liu, Gui-Rong Ye, Fang-Xiang Fu, Jiang-Tao Li, Yun Miao
OBJECTIVE: To investigate the factors associated with the occurrence of transplant renal artery stenosis (TRAS). METHODS: A retrospective analysis was conducted in 26 recipients who developed TRAS and 40 concurrent renal recipients without TRAS. We also conducted a nested case-control study in 14 patients with TRAS (TRAS-SD group) and another 14 non-TRAS recipients who received the allograft from the same donor (non-TRAS-SD group). RESULTS: Compared with those in the concurrent recipients without TRAS, acute rejection (AR) occurred at a significantly higher incidence (P=0...
February 20, 2018: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
Roberto Castellucci, Giulia Primiceri, Pietro Castellan, Michele Marchioni, Carlo D'Orta, Francesco Berardinelli, Fabio Neri, Luca Cindolo, Luigi Schips
OBJECTIVES: Robotic-assisted partial nephrectomy (RAPN) is preferred to radical nephrectomy because it guarantees superior functional outcomes in patients with small renal masses (RMs). Only a few studies so far have evaluated the feasibility of RAPN for the treatment of RM ≥4 cm. The aim of this study is to evaluate the safety and feasibility of RAPN based on a comparison of trifecta and pentafecta rates for RMs ≥4 cm. MATERIAL AND METHODS: We retrospectively analyzed prospectively collected data from an institutional database of patients undergoing RAPN from September 2013 to November 2016...
March 1, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Olamide O Omidele, Natan Davoudzadeh, Michael Palese
Background and Objectives: The learning curve for achieving desirable perioperative outcomes in robot-assisted partial nephrectomy (RAPN) has not been well studied. Information is available regarding "trifecta" outcomes of no complications, no positive margins, warm ischemia time (WIT) of ≤25 minutes, and a ≤15% decrease in postoperative glomerular filtration rate (GFR). This study was conducted to assess the impact of the learning curve on surgical outcomes in patients undergoing RAPN...
January 2018: JSLS: Journal of the Society of Laparoendoscopic Surgeons
S K Frees, R Mager, H Borgmann, W Jäger, C Thomas, A Haferkamp
BACKGROUND: Several new treatment strategies have emerged in the treatment of small renal masses (<4 cm in diameter). Active surveillance and ablative techniques have been introduced but it remains unclear which patients will benefit the most from these new treatment options. A surgical approach remains standard of care. In recent decades, radical nephrectomy has been replaced by nephron-sparing surgery for the management of small renal masses. RESULTS: In addition to the open partial nephrectomy, which is considered the standard approach, the number of surgeries performed using minimally invasive techniques is increasing...
March 2018: Der Urologe. Ausg. A
Ercan Malkoç, Matthew J Maurice, Oktay Akça, Önder Kara, Homayoun Zargar, Hiury Andrade, Daniel Ramirez, Peter Caputo, Robert Stein, Demirjian Sevag, Jihad H Kaouk
AIM: To describe the pathological characteristics of the peritumoral non-neoplastic renal parenchyma (NNRP) and to investigate their impact on long-term renal function after partial nephrectomy. MATERIALS AND METHODS: In our institutional robotic partial nephrectomy database, we identified 394 cases with pathological assessment of the NNRP and long-term postoperative renal functional follow-up. The NNRP was classified as normal (healthy renal parenchyma) or abnormal, based on the presence of arteriosclerosis, glomerulosclerosis, interstitial fibrosis, interstitial inflammation, and/or tubulopapillary hyperplasia...
February 16, 2018: Journal of Nephrology
Mingshuai Wang, Xingyu Mu, Feiya Yang, Yinong Niu, Nianzeng Xing
OBJECTIVE: To evaluate the efficacy and safety of self-retaining barbed suture in renorrhaphy during laparoscopic partial nephrectomy by comparing surgical outcomes in a prospective randomized manner. MATERIAL AND METHODS: From July 2014 to July 2015, a total of 60 patients with T1 renal tumor were randomized into two equal groups: self-retaining barbed suture (SRBS) and conventional absorbable polyglactin suture (non-SRBS group). All patients were treated by retroperitoneal laparoscopic partial nephrectomy...
February 15, 2018: Minimally Invasive Therapy & Allied Technologies: MITAT
Robert S Venick, Douglas G Farmer, Jose R Soto, Jorge Vargas, Hasan Yersiz, Fady M Kaldas, Vatche G Agopian, Jonathan R Hiatt, Sue V McDiarmid, Ronald W Busuttil
BACKGROUND: Pediatric liver transplantation (pLTx) has been the standard of care for children with liver failure since the 1980s. This study examined the world's largest single-center experiences and aimed to identify unique pre-operative predictors of early graft and patient survival for primary (1º-pLTx) and re-transplantation (Re-pLTx). STUDY DESIGN: An IRB approved, retrospective study of all consecutive, isolated pLTx patients ≤ 18 years of age was conducted...
February 1, 2018: Journal of the American College of Surgeons
Hidekazu Tachibana, Toshio Takagi, Tsunenori Kondo, Hideki Ishida, Kazunari Tanabe
OBJECTIVES: To compare surgical outcomes, including renal function and the preserved renal parenchymal volume, between robot-assisted laparoscopic partial nephrectomy and laparoscopic partial nephrectomy using propensity score-matched analyses. METHODS: In total, 253 patients, with a normal contralateral kidney, who underwent laparoscopic partial nephrectomy (n = 131) or robot-assisted laparoscopic partial nephrectomy (n = 122) with renal arterial clamping between 2010 and 2015, were included...
February 4, 2018: International Journal of Urology: Official Journal of the Japanese Urological Association
S V Popov, R G Guseinov, A G Martov, T M Muratov, N B Tabynbaev
Intraoperative occlusion of the renal artery during laparoscopic partial nephrectomy results in warm ischemia and nonspecific hypoxia-reoxygenation alteration of the renal parenchyma cells with a predominant injury to epitheliocytes of the proximal segments of the tubular nephron system. The onset and development of acute kidney injury (AKI) syndrome, which requires immediate correction, is due to the typical pathological process of cell injury. In this regard, the issue of timely diagnosis of AKI remains highly relevant...
December 2017: Urologii︠a︡
B G Guliev, Kh Kh Yagubov
INTRODUCTION: Laparoscopic resection of upper pole kidney tumors is a technically challenging procedure. When tumors are located on the dorsal side of the kidney, the renal-rotation technique may facilitate laparoscopic partial nephrectomy. AIM: To present the technique and results of laparoscopic partial nephrectomy (LPN) for tumors of the upper pole of the kidney with its rotation around the renal hilum. MATERIAL AND METHODS: The study presents a retrospective analysis of the results of 12 patients who underwent LPN for upper pole kidney tumors using the renal-rotation technique...
December 2017: Urologii︠a︡
B K Komyakov, B G Guliev, A I Novikov, Kh Kh Yagubov
AIM: To compare the results of laparoscopic and open partial nephrectomy. MATERIALS AND METHODS: From February 2000 to June 2016, 178 patients (mean age 58.2 years) with stage T1 kidney tumors underwent partial nephrectomy. This cohort included 106 (59.5%) men and 72 (40.5%) women. Open partial nephrectomy was performed in 102 (57.3%) patients (group 1) and laparoscopic partial nephrectomy (LPL) - 76 (42.7%, 2nd group). The majority (92.2%) of patients underwent resection for elective and 14 (7...
December 2017: Urologii︠a︡
R G Guseinov, S V Popov, A N Gorshkov, K V Sivak, A G Martov
AIM: To investigate experimentally ultrastructural and biochemical signs of acute injury to the renal parenchyma after warm renal ischemia of various duration and subsequent reperfusion. MATERIALS AND METHODS: The experiments were performed on 44 healthy conventional female rabbits of the "Chinchilla" breed weighted 2.6-2.7 kg, which were divided into four groups. In the first, control, group included pseudo-operated animals. In the remaining three groups, an experimental model of warm ischemia of renal tissue was created, followed by a 60-minute reperfusion...
December 2017: Urologii︠a︡
Yu G Alyaev, E S Sirota, E A Bezrukov, D N Fiev, M D Bukatov, A V Letunovskii, I Sh Byadretdinov
AIM: To evaluate the possibility of using 3D-printing in the management of patients with localized kidney cancer. MATERIALS AND METHODS: The study comprised five patients with localized kidney cancer who were treated at the Urology Clinic of the I.M. Sechenov First Moscow State Medical University from January 2016 to April 2017. Along with the standard examination, the patients underwent multispiral computed tomography (MSCT) to produce patient-specific 3D-printed models of the kidney tumors using 3D modeling and 3D printing...
December 2017: Urologii︠a︡
Brendan Hermenigildo Dias, Mohammed Shahid Ali, Shiv Dubey, Srinivas Arkalgud Krishnaswamy, Amrith Raj Rao, Deepak Dubey
Introduction: Robot-assisted partial nephrectomy (RAPN) is an established, minimally invasive technique to treat patients with renal masses. The aim of this study was to assess the learning curve (LC) of RAPN, evaluate its impact on perioperative outcomes following RAPN and to study the role of surgeon experience in achieving "trifecta" outcomes following RAPN. Methods: We prospectively analyzed the clinical and pathological outcomes of 108 consecutive patients who underwent RAPN for renal tumors from January 2012 to December 2016 by a laparoscopy trained surgeon with no prior robotic experience...
January 2018: Indian Journal of Urology: IJU: Journal of the Urological Society of India
Yann Loiseau, Justine Bacchetta, Amna Klich, Bruno Ranchin, Delphine Demede, Audrey Laurent, Florent Baudin, Florentine Garaix, Pascal Roy, Pierre Cochat
RTx remains challenging in children under 3 years of age. This single-center study reviewed the medical records of children <3 years transplanted since 1987 (N = 32, Group 1). They were matched for donor type and RTx period with children aged 3-13 years (N = 32, Group 2) and 13-18 years (N = 32, Group 3). There were no between-group significant differences regarding distributions of gender, primary renal disease, proportion of dialysis before RTx, and growth (SDS). Compared to Groups 2 and 3, Group 1 had more peritoneal dialyses (P < ...
January 17, 2018: Pediatric Transplantation
Tawatchai Taweemonkongsap, Chalairat Suk-Ouichai, Ekkarin Chotikawanich, Siros Jitpraphai, Varat Woranisarakul, Patkawat Ramart, Kittipong Phinthusophon, Teerapon Amornvesukit, Sunai Leewansangtong, Sittiporn Srinualnad, Chaiyong Nualyong
INTRODUCTION: Robot-assisted partial nephrectomy (RAPN) with different arterial clamping techniques has increasingly been performed to avoid ischemic injury to nephron. However, postoperative renal function remains controversial. We determine the impact of each renal arterial clamping on surgical and renal outcomes after RAPN. MATERIALS AND METHODS: Patients who underwent RAPN at Siriraj Hospital from 2010 to 2016 were retrospectively reviewed and stratified into 3 cohorts: main-clamp (MAC), selective-clamp, and off-clamp...
January 16, 2018: Urologia Internationalis
Grzegorz Wystrychowski, Wojciech Wystrychowski, Władysław Grzeszczak, Andrzej Więcek, Robert Król, Antoni Wystrychowski
Renal ischemia-reperfusion injury (IRI) induces local inflammation leading to kidney damage. Since pentoxifylline (PTX) and steroids have distinct immunomodulatory properties, we aimed to evaluate for the first time their combined use in IRI-induced acute kidney injury (AKI) and chronic kidney disease (CKD) in rats. In two experiments, PTX (100 mg/kg body weight subcutaneously) was administered 90 min prior to renal IRI or/and methylprednisolone (MP; 100 mg/kg body weight intramuscularly) was infused 60 min after reperfusion of a solitary kidney (AKI model: 45 min ischemia, 48 male Sprague-Dawley rats) or one kidney with excision of contralateral kidney 2 weeks later (CKD model: 90 min ischemia, 38 rats)...
January 11, 2018: International Journal of Molecular Sciences
Beat Foerster, Shoji Kimura, Mihai D Vartolomei, Mohammad Abufaraj, Kilian Gust, Harun Fajkovic, Shahrokh F Shariat, Christian Seitz
PURPOSE OF REVIEW: Various ischemia type during partial nephrectomy for renal cell cancer (RCC) resulted in different postoperative functional outcomes. Our objective was to systematically review the contemporary literature on robot-assisted partial nephrectomy (RPN) and investigate the association of ischemia type and tumor complexity with postoperative functional outcomes of the operated kidney and overall. RECENT FINDINGS: Forty-five of the 99 reports identified were selected for qualitative analysis...
December 22, 2017: Current Opinion in Urology
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