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nephron sparing surgery

Zachary A Hamilton, Robert G Uzzo, Alessandro Larcher, Brian R Lane, Benjamin Ristau, Umberto Capitanio, Stephen Ryan, Sumi Dey, Andres Correa, Madhumitha Reddy, James A Proudfoot, Ryan Nasseri, Kendrick Yim, Sabrina Noyes, Ahmet Bindayi, Francesco Montorsi, Ithaar H Derweesh
BACKGROUND: We compared renal functional outcomes of robotic (RPN) and open partial nephrectomy (OPN) in patients with chronic kidney disease (CKD), a definite indication for nephron-sparing surgery. METHODS: A multicenter retrospective analysis of OPN and RPN in patients with baseline ≥ CKD Stage III [estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 ] was performed. Primary outcome was change in eGFR (ΔeGFR, mL/min/1.73 m2 ) between preoperative and last follow-up with respect to RENAL nephrometry score group [simple (4-6), intermediate (7-9), complex (10-12)]...
March 12, 2018: World Journal of Urology
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
Agnieszka Karbownik, Wojciech Polom, Joanna Porazka, Edyta Szalek, Tomasz Grabowski, Anna Wolc, Matuszewski Marcin, Edmund Grzesowiak
Paracetamol is one of the most common analgesic and antipyretic drugs. Recently intravenous paracetamol has been widely used to treat moderate postoperative pain. Surgery is the main method of treatment of renal cancer. Total or partial nephrectomy can be performed, depending on the size and location of the tumor. Pharmacokinetics of drugs may depend on the type of surgery. The aim of the study was to compare the postinfusion pharmacokinetics of paracetamol in patients after total nephrectomy (TN) and nephron sparing surgery (NSS)...
May 2017: Acta Poloniae Pharmaceutica
Elisabeth Liek, Heiko Wunderlich, Klaus Elsebach, Hubert Göbel, Xaver Krah, Andreas W Krautschick-Wilkens, Josef Schweiger, Gabriel Steiner, Thomas Steiner, Joana Heinzelmann
Due to the recommendations in the urological guidelines to perform nephron-sparing surgery in patients with organ-confined renal cell carcinoma (RCC), the customary therapy regimen changed, but it is not well studied yet whether partial nephrectomy (PN) especially in the elderly is beneficial. From 2000 to 2015, 3,592 patients from 7 clinics undergoing surgery in RCC were identified; 2,323 had T1 tumours. We retrospectively compared the overall survival benefit of patients with T1 RCC who underwent either PN or radical nephrectomy (RN) and studied effects of age and gender...
March 2, 2018: Urologia Internationalis
Nicholas Chua, Konrad Wolfe, Sampi Mehta, Richard N Lodge, Sidath H Liyanage
We describe a rare case of renal lymphangioma presenting as a focal unilateral multicystic renal mass and document the first reported use of triparametric ultrasound (B-mode, Doppler, and contrast-enhanced ultrasound) in its diagnosis and discrimination from other focal multicystic lesions. Renal lymphangiomas are rare, benign, typically developmental lesions composed of cystic dilatation of the lymphatic ducts, usually occurring bilaterally as perinephric collections or parapelvic cysts mimicking hydronephrosis...
December 2017: Radiology case reports
Emily Kim, Stefan Zschiedrich
von Hippel-Lindau (VHL) disease is an autosomal dominant syndrome caused by mutations in the VHL tumor-suppressor gene, leading to the dysregulation of many hypoxia-induced genes. Affected individuals are at increased risk of developing recurrent and bilateral kidney cysts and dysplastic lesions which may progress to clear cell renal cell carcinoma (ccRCC). Following the eponymous VHL gene inactivation, ccRCCs evolve through additional genetic alterations, resulting in both intratumor and intertumor heterogeneity...
2018: Frontiers in Pediatrics
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
Martin W W Janssen, Johannes Linxweiler, Ines Philipps, Zentia Bütow, Stefan Siemer, Michael Stöckle, Carsten-Henning Ohlmann
BACKGROUND: Kidney autotransplantation (KAT) is the ultimate approach for nephron-sparing surgery. It is a rarely used method in renal tumor surgery today as minimal invasive and open techniques for nephron-sparing surgery improve constantly. In this publication, the complication rate and the long-term functional and oncological outcome at a single center are analyzed. METHODS: A prospectively constructed database of patients with renal tumors who underwent renal surgery was retrospectively analyzed to identify patients with KAT and describe surgical and oncological outcomes and to obtain long-term follow-up...
February 20, 2018: World Journal of Surgical Oncology
Ann Buhl Bersang, Sarah Bube, Mikkel Fode, Nessn H Azawi
Background: Germline mutations in succinate dehydrogenase (SDH) are associated with multifocal cancers: pituitary gland tumors, pheochromocytomas, paragangliomas, gastrointestinal stromal tumors, and renal-cell carcinomas (RCCs). SDH-deficient renal-cell carcinoma (SDH-RCC) was first identified in 2004 as an inherited kidney cancer with mutations in the SDH gene. SDH consists of A, B, C, and D units. Mutation in the SDHB gene is the most common mutation in SDH-deficient RCCs. Case Presentation: We report a case of a 51-year-old healthy man diagnosed with SDHB germline mutation and RCCs...
2018: Journal of Endourology Case Reports
M C Kriegmair, N Wagener, S J Diehl, N Rathmann
Renal cell cancer is nowadays predominantly diagnosed in early stages due to the widespread use of sectional imaging for unrelated symptoms. Small renal masses (<4 cm) feature a largely indolent biology with a very low risk for metastasis or even a benign biology in up to 30% of the cases. Consequently, there is a need for less invasive therapeutic alternatives to nephron-sparing surgery. Meanwhile, there is a broad portfolio of local ablation techniques to treat small renal tumors. These include the extensively studied radiofrequency ablation and cryoablation techniques as well as newer modalities like microwave ablation and irreversible electroporation as more experimental techniques...
February 2, 2018: Der Urologe. Ausg. A
Patricio Garcia Marchiñena, Sebastián Tirapegui, Ignacio Tobia Gonzalez, Alberto Jurado, Guillermo Gueglio
OBJECTIVES: The clinical significance of positive surgical margin (PSM) after a Nephron Sparing Surgery (NSS) is controversial. The aim of this study is to evaluate the association between PSM and the risk of disease recurrence in patients with pT1 kidney tumors who underwent NSS. MATERIALS AND METHODS: Retrospective cohort study. A total of 314 patients submitted to a NSS due to stage pT1 renal tumor between January 2010 and June 2015 were included. Recurrence-free survival was estimated...
January 26, 2018: International Braz J Urol: Official Journal of the Brazilian Society of Urology
Xiao-Hui Tan, De-Ying Zhang, Xing Liu, Tao Lin, Da-Wei He, Xu-Liang Li, Guang-Hui Wei
PURPOSE: To describe our clinical experience with nephron sparing surgery (NSS) for bilateral Wilms tumor and evaluate the outcomes of patients treated at one of the largest pediatric medical centers in China. METHODS: Medical records of children with bilateral Wilms tumor undergoing NSS in the Children's Hospital of Chongqing Medical University during a 15-year period were retrospectively analyzed. Data collected were composed of age at surgery, tumor response, tumor rupture during resection, final pathologic margins, use of radiation therapy, pathology reports, renal function, and patient survival...
January 24, 2018: Pediatric Surgery International
Francesco Porpiglia, Riccardo Bertolo, Enrico Checcucci, Daniele Amparore, Matteo Manfredi, Cristian Fiori
Background/Aims/Objectives: Various nephron-sparing approaches were described as part of surgical management for Fraley's syndrome, a rare anatomic variant of the renal vascular anatomy that compresses the upper pole infundibulum resulting in an upper calyceal obstruction and dilatation, with symptoms of flank pain and hematuria. To date, descriptions of minimally invasive correction techniques are anecdotal. METHODS: A retroperitoneal pure laparoscopic approach using the nephron-sparing technique was chosen in the presented case...
January 18, 2018: Urologia Internationalis
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
Aditya P Sharma, Ravimohan Suryanarayana Mavuduru, Girdhar Singh Bora, Sudheer K Devana, Kiruthika Palani, Anupam Lal, Nandita Kakkar, Shrawan K Singh, Arup K Mandal
Introduction and Objective: The RENAL, PADUA and centrality index (C-index) nephrometry scoring systems (SS) have been individually evaluated for their role in predicting trifecta outcomes after nephron-sparing surgery (NSS). However, there is little data on their comparative superiority. The present study was designed to evaluate the predictive value of three SS and to assess interobserver reliability. Materials and Methods: Fifty patients undergoing NSS at our center between January 2014 and April 2016 were included in the study...
January 2018: Indian Journal of Urology: IJU: Journal of the Urological Society of India
A Schmidt, S W Warmann, C Urla, J Fuchs
The overall survival of children with solid tumors has shown a substantial increase in the past decades due to progress in all of the disciplines involved in the treatment. The poor prognosis for advanced stages of disease and the morbidity related to therapeutic procedures are still a challenge. Innovations in the surgical treatment of solid tumors can contribute to increase the survival rate of affected children and to decrease the treatment-related morbidity. Considering these aspects, the successful implementation of innovations is described based on four examples...
January 9, 2018: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Panagiotis Pardalidis, Nick Andriopoulos, Eleni Kosmaoglou, Nick Pardalidis
Introduction: The incidence of urinary leakage is increased as nephron sparing surgery becomes more used for the management of small renal masses. We present an endourologic approach in a patient with a persistent urinary leak after partial nephrectomy by placing two synchronous ureteral stents to improve drainage and avoid further potential surgery. Patients and Method: A 39-year-old patient presented with a urine leak on the fifth postoperative day after an open partial nephrectomy. Initially, the leakage was managed with a placement of a 6F Double-J stent...
2017: Journal of Endourology Case Reports
Senol Tonyali, Artan Koni, Sertac Yazici, Cenk Y Bilen
PURPOSE: To compare the effectiveness of TachoSil and Floseal during laparoscopic nephron-sparing surgery (LNSS), and to evaluate postoperative complications, especially hemorrhage and urinary leakage. MATERIALS AND METHODS: The medical records of all patients that underwent LNSS for a small renal mass (SRM) performed by the same experienced surgeon were retrospectively analyzed. The patients were divided into the following 3 groups, based on hemostatic agent: group 1: no adjuvant hemostatic agent (no AHA); group 2: TachoSil; group 3: Floseal...
January 23, 2017: Urology Journal
Óscar Girón-Vallejo, Darío García-Calderón, Ramón Ruiz-Pruneda, Rosa Cabello-Laureano, Ernesto Doménech-Abellán, José Luis Fuster-Soler, José I Ruiz-Jiménez
Nephron sparing surgery (NSS) is increasingly utilized to treat patients with bilateral Wilms tumor. We present a case of NSS planning using a three-dimensional computerized and printed model of both kidneys with anatomical structures of interest (parenchyma, renal pelvis, major calyx, renal artery, renal vein, and tumor). This model allowed a better understanding of the anatomic relation between the tumor and the normal kidney on each side, improving the surgical planning and the preoperative discussion with the patient's family...
April 2018: Pediatric Blood & Cancer
Laura Morshaeuser, Matthias May, Maximilian Burger, Wolfgang Otto, Georg C Hutterer, Martin Pichler, Tobias Klatte, Peter Wild, Lorenz Buser, Sabine Brookman-May
OBJECTIVE: Due to lacking external validation, molecular biomarkers are currently not applied for risk-stratification of patients with localized renal cell carcinoma. The objective of this study was to externally validate a molecular multi-marker panel included in a previously proposed prognostic nomogram for the prediction of postoperative disease-free survival. METHODS AND MATERIALS: Besides pathologic tumor stage (pT) and ECOG-Performance Status, the nomogram includes 5 molecular markers (Ki-67, p53, VEGFR-1 endothelial or epithelial, and VEGF-D epithelial)...
March 2018: Urologic Oncology
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