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LESS nephrectomy

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https://www.readbyqxmd.com/read/28068796/partial-nephrectomy-for-presumed-renal-cell-carcinoma-incidence-predictors-and-perioperative-outcomes-of-benign-lesions
#1
Tyler Marques Bauman, Aaron Potretzke, Alec J Wright, Brent Alexander Knight, Joel M Vetter, Robert S Figenshau
BACKGROUND: The aim of this study was to investigate the incidence of benign histology after partial nephrectomy (PN) in patients with presumed malignancy from preoperative imaging. Further, preoperative predictors of benign lesions and perioperative outcomes were also assessed. METHODS: A series of patients undergoing PN for renal masses was identified using a prospectively maintained database. Patients were excluded for known genetic conditions, if more than one renal mass was resected, or if standard preoperative imaging was not suspicious for RCC...
January 9, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28011276/excised-parenchymal-mass-during-partial-nephrectomy-functional-implications
#2
W Dong, Z Zhang, J Zhao, J Wu, C Suk-Ouichai, D Aguilar Palacios, E Carabello Antonio, S Babbar, E M Remer, J Li, S Isharwal, J Zabell, S C Campbell
OBJECTIVE: To evaluate whether excised parenchymal mass (EPM) during partial nephrectomy (PN) correlates with functional decline and can serve as a surrogate for functional outcomes. MATERIALS AND METHODS: All 215 patients managed with PN for unifocal renal mass with necessary studies to determine EPM and percent glomerular filtration rate (GFR) and parenchymal mass preserved (both global and specific to the operated kidney) were analyzed. EPM was estimated from the pathologic specimen by subtracting the tumor mass from specimen mass, with both calculated using the elliptical formula...
December 20, 2016: Urology
https://www.readbyqxmd.com/read/28011005/the-enduring-patency-of-primary-inferior-vena-cava-repair
#3
Neel A Mansukhani, George E Havelka, Irene B Helenowski, Heron E Rodriguez, Andrew W Hoel, Mark K Eskandari
BACKGROUND: Inferior vena cava repair after planned and unplanned venotomy is performed by either interposition bypass, patch venopasty, or lateral venorrhaphy and primary repair. Primary repair of the inferior vena cava avoids the use of foreign material and allows an all-autologous repair in an expeditious fashion. The purpose of this study was to demonstrate the utility of inferior vena cava repair, determine the degree of inferior vena cava stenosis, and examine clinical outcomes after primary repair...
December 20, 2016: Surgery
https://www.readbyqxmd.com/read/28008756/cost-effectiveness-and-robot-assisted-urologic-surgery-does-it-make-dollars-and-sense
#4
Ryan W Dobbs, Brenden P Magnan, Nikita Abhyankar, Ashok K Hemal, Ben Challacombe, Jim Hu, Prokar Dasgupta, Francesco Porpiglia, Simone Crivellaro
INTRODUCTION: The introduction of the robotic surgical platform has led to distinct changes in practice patterns and the utilization of minimally invasive surgery in urology. While use of the robotic system is associated with improvements in perioperative outcomes such as estimated blood loss and hospital stay, there are significant fixed and variable costs with the purchase, maintenance and use of the robotics system that has led many authors to investigate the cost effectiveness of robotic urologic surgery...
December 22, 2016: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
https://www.readbyqxmd.com/read/27995214/past-present-and-future-of-laparoscopic-renal-surgery
#5
REVIEW
Kevin Cwach, Louis Kavoussi
Although laparoscopic renal surgery dates to almost 30 years ago, in which the first laparoscopic nephrectomy was performed in 1990, the history of laparoscopy extends back over 100 years, when laparoscopy was first performed on dogs. Over the last 30 years, laparoscopic renal surgery has seen many advancements in technology and technique. With the introduction of robotics and new instruments, renal surgery is becoming increasingly less invasive, and patients are having improved operative outcomes. As new technology develops, the envelope will continue to be pushed by urologists with the hope of improvement of patient outcomes and satisfaction...
December 2016: Investigative and Clinical Urology
https://www.readbyqxmd.com/read/27957308/single-incision-laparoscopy-surgery-a-systematic-review
#6
REVIEW
Sasan Saeed Far, Sepide Miraj
BACKGROUND: Laparoscopic surgery is a modern surgical technique in which operations are performed far from their location through small incisions elsewhere in the body. OBJECTIVE: This systematic review is aimed to overview single-incision laparoscopy surgery. METHODS: This systematic review was carried out by searching studies in PubMed, Medline, Web of Science, and IranMedex databases. The initial search strategy identified about 87 references...
October 2016: Electronic Physician
https://www.readbyqxmd.com/read/27955859/initial-experience-with-the-new-da-vinci-single-port-robot-assisted-platform
#7
R Ballestero Diego, S Zubillaga Guerrero, D Truan Cacho, C Carrion Ballardo, G Velilla Diez, P Calleja Hermosa, J L Gutiérrez Baños
OBJECTIVE: To describe our experience in the first cases of urological surgeries performed with the da Vinci single-port robot-assisted platform. MATERIAL AND METHODS: We performed 5 single-port robot-assisted surgeries (R-LESS) between May and October 2014. We performed 3 ureteral reimplant surgeries, one ureteropyeloplasty in an inverted kidney and 1 partial nephrectomy. The perioperative and postoperative results were collected, as well as a report of the complications according to the Clavien classification system...
December 9, 2016: Actas Urologicas Españolas
https://www.readbyqxmd.com/read/27939815/patient-factors-associated-with-30-day-complications-after-partial-nephrectomy-a-contemporary-update
#8
Harras B Zaid, William P Parker, Christine M Lohse, John C Cheville, Stephen A Boorjian, Bradley C Leibovich, R Houston Thompson
INTRODUCTION: Patient-level factors associated with perioperative complications after partial nephrectomy (PN) have not been well described in a contemporary series. METHODS: Single-institution retrospective study evaluating patients undergoing open, laparoscopic, and robotic PN between 2001 and 2012. Univariable and multivariable logistic regression models were evaluated to assess factors associated with complications within 30 days of surgery. RESULTS: We identified 1,763 patients who underwent 1,773 PNs between 2001 and 2012...
December 6, 2016: Urologic Oncology
https://www.readbyqxmd.com/read/27919577/primary-cic-dux4-round-cell-sarcoma-of-the-kidney-a-treatment-refractory-tumor-with-poor-outcome
#9
Sébastien Bergerat, Philippe Barthelemy, Pascal Mouracade, Hervé Lang, Christian Saussine, Véronique Lindner, Didier Jacqmin
The CIC-DUX4 sarcoma is a subset of the undifferentiated small round cell sarcoma family, presently recognized as a new clinicopathological entity. It is a rare and highly aggressive tumor usually arising in the soft parts of the limbs and the trunk. Only a very few cases of primitive visceral CIC-DUX4 have been hitherto described. We report the case of a 29 year-old male patient with a primary CIC-DUX4 sarcoma of the kidney with lung metastasis. The outcome of the disease was rapidly unfavorable. Despite radical nephrectomy, the patient experienced an early local retroperitoneal recurrence associated with lung and liver metastases...
November 24, 2016: Pathology, Research and Practice
https://www.readbyqxmd.com/read/27917649/percutaneous-externally-assembled-laparoscopic-vs-laparoendoscopic-single-site-nephrectomy-in-a-porcine-model-a-prospective-randomized-blinded-study
#10
Mohamed Keheila, Jim K Shen, Daniel Faaborg, Patrick Yang, Salim Cheriyan, Samuel Abourbih, Nazih Khater, Michael Hill, D Duane Baldwin
OBJECTIVE: To compare the outcomes between laparoendoscopic single-site (LESS) and a novel percutaneous externally assembled laparoscopic (PEAL) nephrectomy in an in vivo porcine model. MATERIALS AND METHODS: Ten female farm pigs were randomized to LESS nephrectomy (5) or PEAL nephrectomy (5). Operative times, estimated blood loss, and intraoperative and postoperative complications were compared. The surgeons used a Likert scale to grade difficulty of peritoneal access, port placement, tool assembly, hilar dissection, closure, and overall difficulty of surgery...
January 5, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/27896577/modified-laparoscopic-simple-enucleation-with-single-layer-suture-technique-versus-standard-laparoscopic-partial-nephrectomy-for-treating-localized-renal-cell-carcinoma
#11
Qun Lu, Xiaozhi Zhao, Changwei Ji, Suhan Guo, Guangxiang Liu, Shiwei Zhang, Xiaogong Li, Weidong Gan, Hongqian Guo
OBJECTIVES: To compare modified laparoscopic simple enucleation (MLSE) and standard laparoscopic partial nephrectomy (SLPN) for treating localized renal cell carcinoma in our large institutional experience. METHODS: We evaluated 385 consecutive patients who underwent MLSE or SLPN for renal tumors in our institution from January 2013 to December 2015 in terms of perioperative pathological and oncologic outcome variables. During MLSE, the single-layer suture technique was performed for renal reconstruction...
November 28, 2016: International Urology and Nephrology
https://www.readbyqxmd.com/read/27889493/partial-vs-radical-nephrectomy-for-t1-t2-renal-masses-in-the-elderly-comparison-of-complications-renal-function-and-oncologic-outcomes
#12
Julie Y An, Mark W Ball, Michael A Gorin, Jiwon J Hong, Michael H Johnson, Christian P Pavlovich, Mohamad E Allaf, Phillip M Pierorazio
OBJECTIVE: To compare outcomes of partial nephrectomy (PN) and radical nephrectomy (RN) in patients 65 years and older. MATERIALS AND METHODS: Our institutional renal mass registry was queried for patients 65 and older with solitary cT1-T2 renal mass resected by PN or RN. Clinicopathologic features and perioperative outcomes were compared between groups. Renal function outcomes measured by change in estimated glomerular filtration rate (eGFR) and freedom from eGFR< 45 mL/min/1...
November 23, 2016: Urology
https://www.readbyqxmd.com/read/27867846/what-s-the-best-minimal-invasive-approach-to-pediatric-nephrectomy-and-heminephrectomy-conventional-laparoscopy-cl-single-site-less-or-robotics-ras
#13
REVIEW
Holger Till, Ali Basharkhah, Andras Hock
BACKGROUND: Conventional laparoscopy (CL) using 3-5 mm ports has become the goldstandard for pediatric nephrectomy (N), heminephrectomy (HN) and heminephrecto-ureterectomy (HNU) for many years now. Recently the spectrum of minimal invasive surgery (MIS) has been extended by variants like laparoendoscopic single-site surgery (LESS) or robot-assisted surgery (RAS). However such technical developments tend to drive surgical euphoria and feasibility studies, but may miss adequate academic research about function and proven patients' benefits...
October 2016: Translational pediatrics
https://www.readbyqxmd.com/read/27864122/sclerosing-tfeb-rearrangement-renal-cell-carcinoma-a-recurring-histologic-pattern
#14
Sean R Williamson, John N Eble, Nallasivam Palanisamy
Renal cell carcinoma with TFEB rearrangement [t(6;11)(p21;q13)] was initially recognized to be composed of dual populations of large cells with clear cytoplasm and small cells forming rosettes around hyaline material. With increasing awareness, however, the spectrum of described morphology has been found to be more heterogeneous. We report a 54 year-old woman who underwent partial nephrectomy for a 2.4 cm renal mass, composed of fibrosis, hyalinization, calcification and ossification, and a smaller component of epithelioid cells...
November 15, 2016: Human Pathology
https://www.readbyqxmd.com/read/27862788/robot-assisted-partial-nephrectomy-continued-refinement-of-outcomes-beyond-the-initial-learning-curve
#15
David J Paulucci, Ronney Abaza, Daniel D Eun, Ashok K Hemal, Ketan K Badani
OBJECTIVES: To evaluate trends in peri-operative outcomes of 250 consecutive cases beyond the initial learning curve (LC) of robot-assisted partial nephrectomy (RAPN) among multiple surgeons. PATIENTS AND METHODS: A multi-institutional database was used to evaluate trends in patient demographics (e.g. age, gender, comorbidities), tumour characteristics (e.g. size, complexity) and peri-operative outcomes (e.g. warm ischaemia time [WIT], operating time, complications, estimated blood loss [EBL], trifecta achievement) in consecutive cases 50-300 (n = 960) from 2008 to 2016 among four experienced surgeons...
November 8, 2016: BJU International
https://www.readbyqxmd.com/read/27860149/management-and-outcomes-of-patients-with-renal-medullary-carcinoma-a-multicentre-collaborative-study
#16
Amishi Y Shah, Jose A Karam, Gabriel G Malouf, Priya Rao, Zita D Lim, Eric Jonasch, Lianchun Xiao, Jianjun Gao, Ulka N Vaishampayan, Daniel Y Heng, Elizabeth R Plimack, Elizabeth A Guancial, Chunkit Fung, Stefanie R Lowas, Pheroze Tamboli, Kanishka Sircar, Surena F Matin, W Kimryn Rathmell, Christopher G Wood, Nizar M Tannir
OBJECTIVE: To describe the management strategies and outcomes of patients with renal medullary carcinoma (RMC) and characterise predictors of overall survival (OS). PATIENTS AND METHODS: RMC is a rare and aggressive malignancy that afflicts young patients with sickle cell trait; there are limited data on management to date. This is a study of patients with RMC who were treated in 2000-2015 at eight academic institutions in North America and France. The Kaplan-Meier method was used to estimate OS, measured from initial RMC diagnosis to date of death...
November 8, 2016: BJU International
https://www.readbyqxmd.com/read/27854201/stent-assisted-detachable-coil-embolization-of-wide-necked-renal-artery-aneurysms
#17
Umberto Marcello Bracale, Donatella Narese, Ilaria Ficarelli, Mario De Laurentis, Flavia Spalla, Ettore Dinoto, Gaetano Vitale, Domenico Solari, Guido Bajardi, Felice Pecoraro
Renal artery aneurysms (RAAs) are rare with an estimated incidence of 0.1% in the general population, and they represent approximately 25% of all visceral aneurysms. The gold standard of treatment is open surgery, but it is associated with a high risk of nephrectomy, mortality, and morbidity. Less invasive endovascular therapies are becoming increasingly common for the treatment of RAAs. Here, we aimed to report three cases of wide-necked complex renal artery aneurysms treated endovascularly using stent-assisted coil embolization with self-expandable stent nitinol Solitaire AB and Concerto Axium coils...
November 17, 2016: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
https://www.readbyqxmd.com/read/27845279/-the-results-of-laparoscopic-partial-nephrectomy-depending-on-the-type-of-access-and-the-tumour-size
#18
R Naghiyev, S Imamverdiyev, O Sanli
Aim - retrospective comparative analysis of results of laparoscopic partial nephrectomy (LPN) depending on the type of access and the size of the tumor. The study included 170 patients undergoing LPN during the period from 2010 to 2015 years. Among the patients was 108 males (63.5%) and 62 women (36.5%) ranging in age from 17 to 80 years (average age 56,6±0.9 years). Depending on the type of access and the size of the tumor patients divided into 4 subgroups-154 patients who performed transperitoneal LRP, 16 patients undergoing retroperitoneal partial nephrectomy, 117 patients with tumor less than 4 cm and 53 patients with tumor more than 4 cm...
October 2016: Georgian Medical News
https://www.readbyqxmd.com/read/27843214/retroperitoneoscopic-nephrectomy-for-benign-nonfunctioning-kidneys-training-and-outcome
#19
Yusuf Saifee, Ramya Nagarajan, Syed Javed Qadri, Amlan Sarmah, Suresh Kumar, Bipin Chandra Pal, Pranjal Modi
INTRODUCTION: Between the two techniques of laparoscopic nephrectomy, retroperitoneoscopy has certain distinct advantages over transperitoneal access but may be a more difficult technique to learn. We present our experience of training novices in retroperitoneoscopic nephrectomy with a good outcome, making it a standard of care for nephrectomy at our institute. METHODS: The aim of this study was to report the initial experience, learning curve, and outcome of retroperitoneoscopic nephrectomy by novices under a mentored approach...
October 2016: Indian Journal of Urology: IJU: Journal of the Urological Society of India
https://www.readbyqxmd.com/read/27825746/comparative-study-of-hybrid-laparoendoscopic-single-site-less-partial-nephrectomy-and-conventional-multiport-laparoscopy
#20
C Redondo, C Esquinas, E Meilán, A García-Tello, I Arance, J C Angulo
OBJECTIVE: To investigate the surgical and oncological outcomes of hybrid laparoendoscopic single-site (LESS) in partial nephrectomy with reusable components compared with multiport laparoscopy. MATERIAL AND METHOD: Hybrid LESS technique with auxiliary 3.5mm trocar (n=20) was compared with conventional multiport laparoscopy (n=26) by a prospective, paired, nonrandomized, and comparative study in partially nephrectomized patients. RESULTS: Follow-up average was 31±18...
November 5, 2016: Actas Urologicas Españolas
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