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https://www.readbyqxmd.com/read/28937805/laparoscopic-partial-nephrectomy-a-narrative-review-and-comparison-with-open-and-robotic-partial-nephrectomy
#1
Andrew M Ng, Paras H Shah, Louis R Kavoussi
INTRODUCTION: Kidney cancer ranks among the top 10 most prevalent cancers in Western society, ∼90% of which are renal cell carcinomas. There has been a paradigm shift in the management of small renal masses with strong emphasis now placed on nephron-sparing surgery and increased utilization of laparoscopic approaches to partial nephrectomy. In this review, the current state of laparoscopic partial nephrectomy (LPN) is discussed. EVIDENCE ACQUISITION: The PubMed database was queried using the MeSH terms "laparoscopy" and "nephrectomy," as well as the search term "partial...
September 22, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28867583/-hybrid-operating-room-for-what
#2
M Benoit, A Bouvier, P Bigot
Hybrid operating rooms (HOR) are rooms that mix interventional radiology and surgical equipments. They are usually used in heart, vascular, orthopedic and neurosurgery, and make it possible to consider new minimally invasive procedures in urology. Thanks to these, we developed a new partial nephrectomy technique without renal pedicle clamping and without ischemia. Renal cancer is now diagnosed at localized stage in most of the cases, and its treatment is mostly based on nephron sparing surgery. However, the hemorrhagic character of this intervention requires a renal pedicle clamping whose long-term consequences on renal function are discussed...
August 31, 2017: Progrès en Urologie
https://www.readbyqxmd.com/read/28836063/prognostic-significance-of-fuhrman-grade-and-age-for-cancer-specific-and-overall-survival-in-patients-with-papillary-renal-cell-carcinoma-results-of-an-international-multi-institutional-study-on-2189-patients
#3
H Borgmann, M Musquera, A Haferkamp, A Vilaseca, T Klatte, S F Shariat, A Scavuzzo, M A Jimenez Rios, I Wolff, U Capitanio, P Dell'Oglio, L M Krabbe, E Herrmann, T Ecke, D Vergho, N Huck, N Wagener, S Pahernik, S Zastrow, M Wirth, C Surcel, C Mirvald, K Prochazkova, G Hutterer, R Zigeuner, L Cindolo, M Hora, C G Stief, M May, S D Brookman-May
PURPOSE: Because the prognostic impact of the clinical and pathological features on cancer-specific survival (CSS) and overall survival (OS) in patients with papillary renal cell carcinoma (papRCC) is still controversial, we want to assess the impact of clinicopathological features, including Fuhrman grade and age, on survival in surgically treated papRCC patients in a large multi-institutional series. METHODS: We established a comprehensive multi-institutional database of surgically treated papRCC patients...
August 23, 2017: World Journal of Urology
https://www.readbyqxmd.com/read/28830229/cryoablation-of-renal-angiomyolipoma-an-evaluation-of-safety-and-efficacy
#4
Ahmad Makki, Ole Graumann, Soren Hoyer, Jan Solvig, Oeyvind Oestraat, Mia Gebauer Madsen, Tommy Kjærgaard Nielsen
BACKGROUND: Small series have reported that cryoablation (CA) is a safe and feasible minimally invasive nephron-sparing alternative for the treatment of renal angiomyolipomas (renal AML). The aim of the present study was to investigate the safety and efficacy of CA in patients with renal AML. MATERIALS AND METHODS: A retrospective review of 19 renal AML lesions treated with CA at Aarhus University Hospital, Denmark, over a five-year period. RESULTS: The treatment was performed as laparoscopic-assisted CA on 7 lesions and in the remaining 12 lesions CA was performed as a percutaneous ultrasound guided CA...
August 22, 2017: Journal of Endourology
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
#5
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/28803678/laparoscopic-partial-nephrectomy-with-prior-superselective-embolisation-as-treatment-for-giant-renal-angiomyolipoma
#6
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/28803448/microvascular-and-lymphovascular-tumor-invasion-are-associated-with-poor-prognosis-and-metastatic-spread-in-renal-cell-carcinoma-a-validation-study-in-clinical-practice
#7
Jens Bedke, Johannes Heide, Silvia Ribback, Steffen Rausch, Michela de Martino, Marcus Scharpf, Andrea Haitel, Uwe Zimmermann, Maik Pechoel, Hussam Alkhayyat, Shahrokh F Shariat, Frank Dombrowski, Arnulf Stenzl, Martin Burchardt, Tobias Klatte, Nils Kroeger
OBJECTIVE: To validate microvascular (MVI) and lymphovascular (LVI) invasion as a prognostic factor in renal cell carcinoma patients (pts.) MATERIALS AND METHODS: Data of patients with RCC who underwent radical or nephron sparing surgery were prospectively collected from three academic centers. The occurrence of MVI and LVI was determined with standard staining protocols by experienced pathologists at the time of diagnosis. The association of MVI and LVI with clinicopathological data, metastatic spread and cancer-specific survival (CSS) was evaluated with Fisher's exact tests, binary logistic regression analyses and univariable and multivariable Cox proportional hazard regression models...
August 13, 2017: BJU International
https://www.readbyqxmd.com/read/28802883/neoadjuvant-therapy-for-localized-and-locally-advanced-renal-cell-carcinoma
#8
REVIEW
Ahmet Bindayi, Zachary A Hamilton, Michelle L McDonald, Kendrick Yim, Frederick Millard, Rana R McKay, Steven C Campbell, Brian I Rini, Ithaar H Derweesh
Neoadjuvant Targeted Molecular Therapy in the setting of localized and locally advanced renal cell carcinoma has emerged as a strategy to render primary renal tumors amenable to planned surgical resection in settings where radical resection or nephron-sparing surgery was not thought to be safe or feasible. Presurgical tumor reduction has been demonstrated in a number of studies including a recently published randomized double-blind placebo-controlled study, and an expanding body of literature suggests benefit in select patients...
August 9, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28802570/organ-preservation-is-less-frequently-performed-in-women-surgically-treated-for-papillary-renal-cell-carcinoma-results-of-a-comprehensive-multicenter-study
#9
Ingmar Wolff, Anna Scavuzzo, Umberto Capitanio, Tobias Klatte, Shahrokh F Shariat, Nina Wagener, Stefan Zastrow, Hendrik Borgmann, Laura-Maria Krabbe, Georg Hutterer, Matthias May, Sabine D Brookman-May
OBJECTIVE: To analyze the impact of gender on the clinicopathologic features and survival of patients with surgically treated papillary renal cell carcinoma (papRCC) using a comprehensive international multicenter database. MATERIALS AND METHODS: Data of 2325 patients undergoing surgery for unilateral papRCC between 1984 and 2015 in 17 European and North American centers were retrospectively collated. The impact of clinicopathologic features on the likelihood of nephron-sparing surgery (NSS) was evaluated using a multivariable logistic regression model...
August 9, 2017: Urology
https://www.readbyqxmd.com/read/28801061/european-temporal-trends-in-the-use-of-lymph-node-dissection-in-patients-with-renal-cancer
#10
U Capitanio, G D Stewart, A Larcher, I Ouzaid, B Akdogan, M Roscigno, M Marszalek, P Dell'Oglio, M Salagierski, A Volpe, M C Mir, M Kriegmair, C Terrone, S D Brookman-May, F Montorsi, T Klatte
BACKGROUND: The role of lymph node dissection (LND) in renal cell carcinoma (RCC) is still under debate. We aimed to assess the utilization rates of LND over time in Europe. METHODS: A multi-institutional database of 13,581 RCC patients who underwent radical nephrectomy (RN) or nephron sparing surgery (NSS) between 1988 and 2014 was created within an European consortium. We analysed temporal trends in the frequency of LND by using Joinpoint regression. Logistic regression models were used to identify predictors of LND...
August 3, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28795136/renal-autotransplantation-and-extracorporeal-nephron-sparing-surgery-for-de-novo-renal-cell-carcinoma-in-a-kidney-allograft
#11
Shinichiro Ono, Takashi Kenmochi, Taihei Ito, Naohiro Aida, Kazunori Otsuki, Naotake Akutsu, Michihiro Maruyama, Mamoru Kusaka, Ryoichi Shiroki, Kiyotaka Hoshinaga
De novo renal cell carcinoma (RCC) rarely occurs in kidney allografts; however, the risk of RCC in these patients is 100-fold that of the general healthy population. Although total nephrectomy has been the standard treatment for kidney allograft RCC, several authors have reported that early-stage RCC in kidney allografts was successfully treated with nephron-sparing surgery. We herein describe a new procedure involving renal autotransplantation and extracorporeal nephron-sparing surgery, which was performed to treat de novo RCC near the hilum of a transplanted kidney...
August 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28763900/-application-of-mini-flank-open-nephron-sparing-surgery-via-retroperitoneal-route-for-centrally-located-renal-tumor-treatment-a-single-center-experience
#12
Y N Lu, F Zhang, X Y Hu, N Q Yang, J M Guo, H Wang
Objective: To investigate the safety and feasibility of mini-flank open nephron sparing surgery (MI-OPN) via retroperitoneal route for the treatment of centrally located renal tumor. Methods: From May 2013 to April 2015, twenty-four cases of centrally located renal tumor were treated with MI-OPN via retroperitoneal route in Zhongshan Hospital. All cases were included in this study with whose clinical data and long term follow-up information retrospectively analyzed. Results: With the assistance of intraoperative ultrasonography to confirm tumor location and boundary, MI-OPN was successfully performed in all cases...
July 25, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28753888/intraoperative-imaging-techniques-to-support-complete-tumor-resection-in-partial-nephrectomy
#13
REVIEW
Marlène C H Hekman, Mark Rijpkema, Johan F Langenhuijsen, Otto C Boerman, Egbert Oosterwijk, Peter F A Mulders
CONTEXT: With more complex kidney tumors treated by nephron-sparing surgery (NSS), complete tumor resection is becoming increasingly challenging. Intraoperative imaging may improve the establishment of negative surgical margins. OBJECTIVE: To discuss intraoperative imaging techniques that may help achieve complete tumor resection in NSS of renal tumors. EVIDENCE ACQUISITION: PubMed was searched for English articles on intraoperative imaging during NSS of renal cell carcinoma published after 2005, and a reference search of retrieved articles was performed...
May 12, 2017: European Urology Focus
https://www.readbyqxmd.com/read/28753863/exploratory-subgroup-analyses-of-renal-function-and-overall-survival-in-european-organization-for-research-and-treatment-of-cancer-randomized-trial-of-nephron-sparing-surgery-versus-radical-nephrectomy
#14
Emil Scosyrev, Edward M Messing, Richard Sylvester, Hendrik Van Poppel
BACKGROUND: In the European Organization for Research and Treatment of Cancer (EORTC) randomized trial 30904, nephron-sparing surgery (NSS) reduced the risk of renal dysfunction compared with radical nephrectomy (RN); however, overall survival was better in the RN arm. OBJECTIVE: To determine whether treatment effect on the risk of renal dysfunction and all-cause mortality differed in magnitude across levels of baseline variables. DESIGN, SETTING, AND PARTICIPANTS: This was an exploratory subgroup analysis of EORTC 30904, a phase 3 randomized trial conducted in patients with a small (≤5cm) renal mass and normal contralateral kidney...
April 4, 2017: European Urology Focus
https://www.readbyqxmd.com/read/28741377/renal-cell-carcinoma-alternative-nephron-sparing-treatment-options-for-small-renal-masses-a-systematic-review
#15
Fieke M Prins, Linda G W Kerkmeijer, Anne A Pronk, Evert-Jan P A Vonken, Richard P Meijer, Axel Bex, Maurits M Barendrecht
BACKGROUND: The standard treatment of T1 renal cell carcinoma (RCC) is (partial) nephrectomy. For patients where surgery is not the treatment of choice, for example in the elderly, in case of severe comorbidity, inoperability, or refusal of surgery, alternative treatment options are available. These treatment options include active surveillance (AS), radiofrequency ablation (RFA), cryoablation (CA), microwave ablation (MWA), or stereotactic body radiotherapy (SBRT). In the present overview, the efficacy, safety, and outcome of these different options are summarized, particularly focusing on recent developments...
August 22, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28739404/laparoscopic-partial-nephrectomy-with-sequential-precise-tumor-specific-segmental-renal-artery-clamping-for-multiple-ipsilateral-renal-tumors-a-new-treatment-approach-and-initial-experience
#16
Mingyue Tan, Yongzhi Xu, Dongliang Xu, Juntao Jiang, Wei Zhao, Di Cui, Yuan Ruan, Shujie Xia
OBJECTIVE: To present our surgical approach and initial experience of laparoscopic partial nephrectomy (LPN) with sequential precise tumor-specific segmental renal artery clamping in patients with multiple ipsilateral renal tumors. MATERIALS AND METHODS: Six patients with multiple ipsilateral renal tumors having imperative indications for nephron-sparing surgery underwent LPN with sequential precise tumor-specific segmental renal artery clamping from May 2012 to September 2015...
July 21, 2017: Urology
https://www.readbyqxmd.com/read/28731925/thoracic-paravertebral-block-for-postoperative-pain-management-after-renal-surgery-a-randomised-controlled-trial
#17
Maja Copik, Szymon Bialka, Andrzej Daszkiewicz, Hanna Misiolek
BACKGROUND: Thoracic paravertebral block (ThPVB) combined with general anaesthesia is used in thoracic and general surgery. It provides effective analgesia, reduces surgical stress response and the incidence of chronic postoperative pain. OBJECTIVE: To assess the efficacy of ThPVB in reducing opioid requirements and decreasing the intensity of pain after renal surgery. DESIGN: A randomised, open label study. SETTING: A single university hospital...
September 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28723695/renoprotective-procedures-with-a-cold-ischemia-time-of-60-min-minimize-the-deterioration-of-kidney-function-in-open-nephron-sparing-surgery-for-renal-cell-carcinoma
#18
Hayato Nishida, Atsushi Yamagishi, Mayu Yagi, Hidenori Kanno, Yuta Kurota, Toshihiko Sakurai, Sei Naito, Tomohiro Shibasaki, Hisashi Kawazoe, Osamu Ichiyanagi, Tomoyuki Kato, Akira Nagaoka, Yoshihiko Tomita, Norihiko Tsuchiya
INTRODUCTION: We evaluated whether nephron sparing surgery (NSS) combined with meticulous suturing of the cut stump under clamping with cooling is beneficial for oncological outcomes and also assessed the relationship between cold ischemia time and deterioration of renal function. METHODS: One hundred and six patients with renal cell carcinoma (RCC) were subjected to this procedure. Oncological outcomes and renal function according to the estimated glomerular filtration rate (eGFR) and the tubular excretion rate on renoscintigraphy before and at 12 months after surgery were evaluated...
July 20, 2017: Urologia Internationalis
https://www.readbyqxmd.com/read/28723503/nephron-sparing-for-renal-cell-carcinoma-whenever-possible
#19
Hendrik Van Poppel, Steven Joniau, Maarten Albersen
Open studies have definitely and repeatedly favoured nephron-sparing surgery in improving overall, cancer-specific, and cardiac disease-specific survival in cases with a normal contralateral kidney. However, the only randomised clinical trial could not confirm this superiority of nephron-sparing surgery over radical nephrectomy.
December 15, 2016: European Urology Focus
https://www.readbyqxmd.com/read/28723485/three-dimensional-printing-for-renal-cancer-and-surgical-planning
#20
Mary E Westerman, Jane M Matsumoto, Jonathan M Morris, Bradley C Leibovich
Three-dimensional (3D) stereolithographic models provide tactile and anatomic information that offers advantages over digital 3D reconstructions alone. This technology has the potential to alter preoperative surgical planning and significantly enhance successful performance of complex nephron-sparing surgery.
December 15, 2016: European Urology Focus
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