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Liangsong Zhu, Guangyu Wu, Jianfeng Wang, Jiwei Huang, Wen Kong, Yonghui Chen, Wei Xue, Yiran Huang, Jin Zhang
To investigate the feasibility of the noncontrast-enhanced magnetic resonance angiography (NCE-MRA) to evaluate renal arteries before partial nephrectomy (PN).Retrospective analyzed 479 patients who underwent renal surgery between January 2013 and December 2015 with NCE-MRA or computed tomographic angiography (CTA) renal artery image reconstruction preoperative in our department. The renal artery reconstruction score (RARS) was based on the level of artery visualization in a 4-class criterion, and the R.E.N...
October 2016: Medicine (Baltimore)
Masahiro Sugiura, Takahito Suyama, Manato Kanesaka, Ayumi Fujimoto, Kyokushin Hou, Kazuhiro Araki, Hiroshi Masuda, Satoko Kojima, Yukio Naya
OBJECTIVES: The aim of this study was to investigate the clinical usefulness for prediction of outcome of laparoscopic partial nephrectomy (LPN) using the R.E.N.A.L nephrometry scoring system (RNS) and centrality index score (C-index). MATERIALS AND METHODS: We retrospectively reviewed 64 patients who underwent LPN from 2010 to 2014 in our institution. The RNS and C-index scores were assigned according to the described protocols for their systems. The relationships between the patients' scores before surgery and the outcomes of LPN, warm ischemia time (WIT), operative time (ORT), estimated blood loss (EBL), and percent change in estimated glomerular filtration rate (eGFR) were analyzed retrospectively...
October 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Faruk Ozgor, Abdulmuttalip Simsek, Ozgu Aydogdu, Onur Kucuktopcu, Omer Sarilar, Ahmet Yalcin Berberoglu, Mehmet Fatih Ahbulut, Murat Binbay
OBJECTIVES: To evaluate the possible role of an hemostatic matrix on hemostasis, perioperative outcomes and complications in patients who underwent laparoscopic partial nephrectomy (LPN). MATERIALS AND METHODS: Patients charts were analyzed retrospectively and their demographic characteristics, operative parameters and follow-up results were recorded. Patients were divided into two groups, according to those who used an hemostatic matrix as Group 1 (n = 41) and those who did not used as Group 2 (n = 44)...
October 5, 2016: Archivio Italiano di Urologia, Andrologia
Nakul Gupta, Anish Patel, Joe Ensor, Kamran Ahrar, Judy Ahrar, Alda Tam, Bruno Odisio, Stephen Huang, Ravi Murthy, Armeen Mahvash, Rony Avritscher, Stephen McRae, Sharjeel Sabir, Michael Wallace, Surena Matin, Sanjay Gupta
PURPOSE: To describe the incidence of multiple renal artery pseudoaneurysms (PSA) in patients referred for renal artery embolization following partial nephrectomy and to study its relationship to RENAL nephrometry scores. MATERIALS AND METHODS: The medical records of 25 patients referred for renal artery embolization after partial nephrectomy were retrospectively reviewed for the following parameters: size and number of tumors, RENAL nephrometry scores, angiographic abnormalities, technical and clinical outcomes, and estimated glomerular filtration rates (eGFRs) after embolization...
September 28, 2016: Cardiovascular and Interventional Radiology
Fatima Z Husain, Daniel C Rosen, David J Paulucci, John P Sfakianos, Ronney Abaza, Ketan K Badani
OBJECTIVE: To assess the association between the R.E.N.A.L. Nephrometry score, the amount of non-neoplastic parenchymal volume (NNPV) removed, and the renal function decline in patients undergoing robotic partial nephrectomy (RPN). PATIENTS AND METHODS: The Multi-institutional Mount Sinai Kidney Cancer Database was used to identify 1235 patients who underwent RPN between January 2008 and February 2016, of whom 366 had complete data, including NNPV removed. Mann-Whitney U tests and univariable linear regression models were used to assess the relationships between R...
October 2016: Journal of Endourology
Maximilian C Kriegmair, Philipp Mandel, Anett Moses, Julia Lenk, Martin Rothamel, Johannes Budjan, Maurice S Michel, Nina Wagener, Daniel Pfalzgraf
BACKGROUND: Nephrometry scores are designed for standardized reporting of renal tumors and predicting complications. Multiple scores are available, but there is a lack of systematic comparison. PATIENTS AND METHODS: A total of 305 consecutive patients admitted for open partial nephrectomy to 2 urological hospitals were prospectively assessed. Five cases with conversion to radical nephrectomy were excluded from further analysis. RENAL, PADUA, C-index, and NePhRO scores were obtained from preoperative sectional imaging...
August 8, 2016: Clinical Genitourinary Cancer
Ioannis Zachos, Konstantinos Dimitropoulos, Anastasios Karatzas, Michael Samarinas, Argiro Petsiti, Vassilios Tassoudis, Vassilios Tzortzis
OBJECTIVES: Surgical management of small renal masses can be challenging in frail patients and thus modalities such as radiofrequency ablation (RFA) have emerged as valid alternative options. The aim of the current study was to present mid-term oncological and functional results on a series of patients with cT1a renal cell carcinomas (RCCs) who were unfit for surgery and underwent RFA using ultrasound guidance under local anesthesia. METHODS: Data from patients fulfilling the study selection criteria were retrospectively collected...
September 2016: Therapeutic Advances in Medical Oncology
Kyle A Blum, David J Paulucci, Ronney Abaza, Daniel D Eun, Akshay Bhandari, Joan C Delto, Louis S Krane, Ashok K Hemal, Ketan K Badani
OBJECTIVE: To compare renal function outcome between a contemporary cohort of propensity score-matched patients undergoing main renal artery clamping (MAC) alone and those undergoing main renal artery clamping with renal vein clamping (MVAC) during robotic partial nephrectomy. MATERIALS AND METHODS: Patients with a solitary T1 renal mass undergoing robotic partial nephrectomy were propensity score-matched on American Society of Anesthesiologists score, RENAL Nephrometry score, tumor size, tumor laterality, and operating surgeon to provide 66 patients undergoing MAC and 66 patients undergoing MVAC for analysis...
August 26, 2016: Urology
Tobias Simpfendörfer, Claudia Gasch, Gencay Hatiboglu, Michael Müller, Lena Maier-Hein, Markus Hohenfellner, Dogu Teber
INTRODUCTION: Laparoscopic partial nephrectomy (LPN) remains challenging in endophytic and complex kidney tumors as the clear understanding of tumor location and spreading depends on a precise analysis of available imaging. The purpose of this study was to investigate navigated kidney surgery using intraoperative cone-beam computed tomography (CBCT) images in conjunction with a previously proposed method for augmented reality (AR) guidance for safe LPN. MATERIALS AND METHODS: The concept proposed is based on using an intraoperative CBCT scan for (1) marker-based AR guidance for fast and reliable tumor access and (2) enhancement of real-time fluoroscopy images for accurate tumor resection...
October 2016: Journal of Endourology
Riccardo Schiavina, Giacomo Novara, Marco Borghesi, Vincenzo Ficarra, Rajesh Ahlawat, Daniel A Moon, Francesco Porpiglia, Benjamin J Challacombe, Prokar Dasgupta, Eugenio Brunocilla, Gaetano La Manna, Alessandro Volpe, Hema Verma, Giuseppe Martorana, Alexandre Mottrie
OBJECTIVES: To evaluate and compare the correlations between Preoperative Aspects and Dimensions Used for an Anatomical (PADUA) and R.E.N.A.L. [Radius (tumour size as maximal diameter), Exophytic/endophytic properties of the tumour, Nearness of tumour deepest portion to the collecting system or sinus, Anterior (a)/posterior (p) descriptor and the Location relative to the polar line] nephrometry scores and perioperative outcomes and postoperative complications in a multicentre, international series of patients undergoing robot-assisted partial nephrectomy (RAPN) for masses suspicious for renal cell carcinoma (RCC)...
August 16, 2016: BJU International
Filippo Annino, Luca Topazio, Domenico Autieri, Tiziano Verdacchi, Michele De Angelis, Anastasios D Asimakopoulos
BACKGROUND: Airseal represents a new generation of valveless and barrier-free surgical trocars that enable a stable pneumoperitoneum with continuous smoke evacuation and carbon dioxide (CO2) recirculation during surgery. The aim of the current study was to evaluate the potential advantages of the Airseal compared to a standard CO2 insufflator in the field of robotic partial nephrectomy (RPN). METHODS: Between October 2012 and April 2015, two cohorts of 122 consecutive patients with clinically localized renal cell carcinoma underwent RPN by a single surgeon, with the use of a standard CO2 pressure insufflator (Group A, 55 patients) or Airseal (Group B, 67 patients) and were prospectively compared...
August 5, 2016: Surgical Endoscopy
K C Cheng, M K Yiu, S H Ho, T L Ng, H L Tsu, W K Ma
INTRODUCTION: A renal parenchymal clamp has been used at our centre since March 2012. It is used in position over the kidney to achieve optimal vascular control of a tumour while minimising parenchymal ischaemia. This study aimed to report the feasibility, surgical outcome, and oncological control of a kidney clamp in partial nephrectomy. METHODS: This study was conducted at a teaching hospital in Hong Kong. Partial nephrectomies performed from January 2009 to March 2015 were reviewed...
July 29, 2016: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
Newaj Abdullah, Haider Rahbar, Ravi Barod, Deepansh Dalela, Jeff Larson, Michael Johnson, Alon Mass, Homayoun Zargar, Mohamad Allaf, Sam Bhayani, Michael Stifelman, Jihad Kaouk, Craig Rogers
OBJECTIVE: To evaluate the outcomes of robot-assisted partial nephrectomy RAPN after major prior abdominal surgery (PAS) using a large multicentre database. PATIENTS AND METHODS: We identified 1 686 RAPN from five academic centres between 2006 and 2014. In all, 216 patients had previously undergone major PAS, defined as having an open upper midline/ipsilateral incision. Perioperative outcomes were compared with those 1 470 patients who had had no major PAS. The chi-squared test and Mann-Whitney U-test were used for categorical and continuous variables, respectively...
August 2016: BJU International
Sheng-Han Tsai, Jia-Hwia Wang, Yi-Chen Lai, Yen-Hwa Chang, Hsiao-Jen Chung, Luke S Chang
BACKGROUND: Mixed epithelial and stromal tumor of the kidney (MESTK) is a rare tumor, with few malignant cases reported. Occurring mostly in middle-aged women, it is characterized by a biphasic pathological structure. METHODS: This study retrospectively reviewed the imaging findings and medical records of six MESTK cases of a single institution in a 10-year period. RESULTS: All of the patients were middle-aged women without hormone therapy history...
October 2016: Journal of the Chinese Medical Association: JCMA
Vignesh T Packiam, Charles U Nottingham, Andrew J Cohen, Shane M Pearce, Arieh L Shalhav, Scott E Eggener
INTRODUCTION: Perioperative administration of aspirin for high-risk urologic procedures is controversial. We evaluated whether continuation of perioperative aspirin alters bleeding complications in patients who undergo robotic partial nephrectomy (RPN). MATERIALS AND METHODS: Retrospective review identified 214 consecutive patients who underwent RPN at our institution from May 2012 to March 2015. Comparisons were performed between 49 patients continuing aspirin (81 mg), 34 patients holding aspirin for at least 7 days before surgery, and 131 patients who had never taken aspirin...
September 2016: Journal of Endourology
Hong-Kai Wang, Xiao-Jian Qin, Chun-Guang Ma, Guo-Hai Shi, Hai-Liang Zhang, Ding-Wei Ye
BACKGROUND: Laparoscopic partial nephrectomy (LPN) is not a novel but a relatively technically challenging surgical procedure. Off-clamp LPN with zero ischemia can completely eliminate ischemic reperfusion injury to the kidney. The purpose of this study was to evaluate the safety and functional outcome of nephrometry score-guided off-clamp technique in LPN. METHODS: A total of 44 patients underwent LPN between January 2015 and July 2015 for renal mass with radius, exophytic/endophytic, nearness to sinus, anterior/posterior location (RENAL) score 4 were enrolled...
2016: World Journal of Surgical Oncology
Stella K Kang, William C Huang, Edward Y Skolnik, Debra A Gervais, R Scott Braithwaite, Pari V Pandharipande
OBJECTIVE: The purpose of this article is to compare the effectiveness of a treatment algorithm for small renal tumors incorporating the nephrometry score, a renal tumor anatomy scoring system developed by urologists, with the current standard of uniformly recommended partial nephrectomy in patients with mild-to-moderate chronic kidney disease (CKD). MATERIALS AND METHODS: We developed a state-transition microsimulation model to project life expectancy (LE) in hypothetic patients with baseline mild or moderate CKD undergoing treatment of small renal masses...
August 2016: AJR. American Journal of Roentgenology
Jeffrey J Leow, Nathaniel H Heah, Steven L Chang, Yew Lam Chong, Keng Siang Png
PURPOSE: We evaluate the current literature comparing outcomes of robotic vs laparoscopic partial nephrectomy. MATERIALS AND METHODS: We performed a literature search according to Cochrane guidelines up to December 2015 including studies comparing robotic and laparoscopic partial nephrectomy, and we compared baseline patient and tumor characteristics. We performed a meta-analysis to evaluate safety, effectiveness and functional outcomes of robotic vs laparoscopic partial nephrectomy using weighted mean difference and inverse variance pooled risk ratios, respectively...
June 10, 2016: Journal of Urology
Homayoun Zargar, Oktay Akca, Peter Caputo, Daniel Ramirez, Onder Kara, Hiury S Andrade, Robert J Stein, Jihad H Kaouk
PURPOSE: To compare the early BMI changes postoperatively between patients undergoing open partial nephrectomy (OPN) and robotic partial nephrectomy (RPN). METHODS: Patients undergoing open NSS for a single renal tumor between 2010 and 2013 were retrospectively selected for the study. These patients were matched with RPN patients based on preoperative BMI and tumor R.E.N.A.L nephrometry score (1:1 matching). RESULTS: A total of 568 patients (284 pairs) met our inclusion criteria...
June 7, 2016: World Journal of Urology
Akari Komatsuda, Kazuhiro Matsumoto, Akira Miyajima, Gou Kaneko, Ryuichi Mizuno, Eiji Kikuchi, Mototsugu Oya
BACKGROUND: Laparoscopic partial nephrectomy is one of the major surgical techniques for small renal masses. However, it is difficult to manage cutting and suturing procedures within acceptable time periods. To overcome this difficulty, we applied a three-dimensional (3D) video system with laparoscopic partial nephrectomy, and evaluated its utility. MATERIALS AND METHODS: We retrospectively enrolled 31 patients who underwent laparoscopic partial nephrectomy between November 2009 and June 2014...
2016: Asian Pacific Journal of Cancer Prevention: APJCP
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