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https://www.readbyqxmd.com/read/28532200/spinal-analgesia-improves-surgical-outcome-after-open-nephrectomy-for-renal-cell-carcinoma-a-randomized-controlled-study
#1
Mascha Thurm, Britt-Inger Kröger Dahlin, Ola Winsö, Börje Ljungberg
OBJECTIVE: This study evaluated whether more effective perioperative analgesia can be part of a multimodal approach to minimizing morbidity and improving postoperative management after the open surgical approaches frequently used in the treatment of renal cell carcinoma (RCC). The aim of the study was to determine whether spinal anesthesia with clonidine can enhance postoperative analgesia, speed up mobilization and reduce the length of hospital stay (LOS). MATERIALS AND METHODS: Between 2012 and 2015, 135 patients with RCC were randomized, in addition to general anesthesia, to receive either spinal analgesia with clonidine or epidural analgesia, stratified to surgical technique...
May 22, 2017: Scandinavian Journal of Urology
https://www.readbyqxmd.com/read/28527565/-advancement-in-the-treatment-of-renal-carcinoma
#2
Arnaud Méjean
Partial nephrectomy is the gold standard for the renal tumours less than 7 to 10cm whenever feasible in order to preserve renal function. The extension of nephron-sparing surgery using a mini-invasive approach is possible by robotic surgery. Radical nephrectomy is mandatory in the other situations and especially in case of locally advanced renal carcinoma. The place of cytoreductive nephrectomy in metastatic renal cell carcinoma is the purpose of the CARMENA trial. Tyrosine kinase inhibitors are currently the first line treatment; but in the near future new immunotherapy by checkpoints molecules could crucially change the treatment of metastatic renal cell carcinoma...
May 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/28503232/cytoreductive-nephrectomy-in-the-modern-era-predictors-of-use-morbidity-and-survival
#3
Brian J Minnillo, William Tabayoyong, John J Francis, Matthew J Maurice, Hui Zhu, Simon Kim, Robert Abouassaly
INTRODUCTION: To determine tumour, patient, and provider factors associated with cytoreductive nephrectomy (CN) use and to identify those factors that predicted short-term and long-term surgical outcomes. METHODS: We performed a retrospective review (1998-2011) of the National Cancer Database, a U.S. population-based oncology outcomes database. The review included 36 549 patients with metastatic renal cell carcinoma (mRCC). We assessed predictors of CN use, length of stay (LOS), 30-day readmission, and 30-day mortality using multivariable logistic regression...
May 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/28484665/retrospective-review-of-pediatric-blunt-renal-trauma-a-single-institution-s-five-year-experience
#4
Carly R Richards, Margaret E Clark, Ronald S Sutherland, Russell K Woo
Children are at higher risk of renal injury from blunt trauma than adults due to a variety of anatomic factors such as decreased perirenal fat, weaker abdominal muscles, and a less ossified thoracic cage. Non-operative management is gaining in popularity for even major injuries, although there are no universally accepted guidelines. We present a retrospective review of pediatric major blunt renal injuries (grade 3 or higher) at a children's hospital in Hawai'i over a 5-year period. Medical records were examined between January 2009 and September 2014 from Kapi'olani Medical Center for Women and Children in Honolulu, Hawai'i...
May 2017: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
https://www.readbyqxmd.com/read/28469302/perioperative-complications-and-postoperative-outcomes-of-partial-nephrectomy-for-renal-cell-carcinoma-does-indication-matter
#5
Vivek Venkatramani, Santosh Kumar, J Chandrasingh, Antony Devasia, Nitin S Kekre
INTRODUCTION: The aim of the study was to determine whether perioperative complications and postoperative outcomes varied with the indication of partial nephrectomy (PN). MATERIALS AND METHODS: We reviewed data of 184 consecutive PN for suspected renal cell carcinoma operated between January 2004 and December 2013. Complications using the Clavien-Dindo classification were compared between surgeries for absolute indications (chronic renal failure, bilateral tumors, or solitary kidney), those for relative indications (comorbid illnesses with the potential to affect renal function) and elective indications (patients without risk factors)...
April 2017: Indian Journal of Urology: IJU: Journal of the Urological Society of India
https://www.readbyqxmd.com/read/28464554/does-training-of-fellows-affect-peri-operative-outcomes-of-robot-assisted-partial-nephrectomy
#6
Zine-Eddine Khene, Benoit Peyronnet, Elise Bosquet, Benjamin Pradère, Corentin Robert, Tarek Fardoun, Solène-Florence Kammerer-Jacquet, Grégory Verhoest, Nathalie Rioux-Leclercq, Romain Mathieu, Karim Bensalah
OBJECTIVE: To evaluate the impact of fellows' involvement on the peri-operative outcomes of robot-assisted partial nephrectomy (RAPN). MATERIALS AND METHODS: We analysed 216 patients who underwent RAPN for a small renal tumour. We stratified our cohort into two groups according to the involvement of a fellow surgeon during the procedure: expert surgeon operating alone (expert group) and fellow operating under the supervision of the expert surgeon (fellow group)...
May 2, 2017: BJU International
https://www.readbyqxmd.com/read/28464180/comorbidity-is-a-competing-factor-for-disease-recurrence-postnephrectomy
#7
Lael Reinstatler, Zachary Klaassen, Rabii Madi, Martha K Terris, Kelvin A Moses
OBJECTIVE: There is a relation between tumor stage and grade with the risk of cancer recurrence in patients undergoing surgical treatment for kidney cancer. The association of patient comorbidity with disease recurrence is less well characterized. The objective of this study was to explore the association between comorbidity and the recurrence of kidney cancer. METHODS: We performed a retrospective analysis of 263 patients who received a partial or radical nephrectomy from January 1, 2000 through April 30, 2013...
May 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28463213/-relation-between-severity-of-atherosclerosis-and-progression-of-renal-disease-in-nephrectomized-patients
#8
Enrique Dorado, María V Mouesca, Marina Khoury, Diego Barreiro, Norberto Lafós, Silvia Rausch
Radical nephrectomy is associated with a progressive decline in renal function. Clinical parameters in post-nephrectomy insufficiency were described but the impact of histopathologic vascular findings in the non-neoplastic kidney of nephrectomy specimen, has been poorly studied. Our aim was to evaluate whether the severity of atherosclerosis in non-neoplastic renal tissue predicts the evolution of glomerular filtration rate in patients undergoing total nephrectomy. Thirty-one non-donor patients with unilateral radical nephrectomy were included...
2017: Medicina
https://www.readbyqxmd.com/read/28442383/the-utility-of-axial-abdominal-imaging-after-partial-nephrectomy-for-t1-renal-cell-carcinoma-surveillance
#9
Igor Sorokin, Noah E Canvasser, Vitaly Margulis, Yair Lotan, Ganesh Raj, Arthur Sagalowsky, Jeffrey C Gahan, Jeffrey A Cadeddu
INTRODUCTION: The overall recurrence rate of T1 renal cell carcinoma is low. We evaluated abdominal imaging after partial nephrectomy based on current guidelines for T1 renal cell carcinoma surveillance. MATERIALS & METHODS: We retrospectively reviewed T1 renal cell carcinoma patients who underwent partial nephrectomy between 2006-2012 followed by abdominal imaging at our institution. Primary and secondary outcomes were incidence and timing of imaging diagnosed abdominal recurrences, respectively...
April 22, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28427128/-the-application-value-of-contrast-enhanced-ultrasound-in-the-surgery-of-renal-masses
#10
M H Liu, J H Shi, Q M H Wangqi, Y Q Lin, Z X Sun
Objective: To investigate the clinical value of contrast-enhanced ultrasound in the diagnosis of renal masses. Methods: A total of 50 patients with renal masses who underwent partial nephrectomy were analyzed from January 2014 to October 2016 in the Department of Urology of China-Japan Union Hospital of Jilin University.In the intraoperative contrast-enhanced ultrasound, the characteristics of ultrasound imaging were recorded including location, size, boundary, echo, real-time internal and peripheral blood and renal pelvis distance, artery, guidance on the selection of surgical methods, intraoperative real-time estimation of the extent of tumor resection...
April 18, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28413381/delayed-cytoreductive-nephrectomy-following-three-years-of-targeted-therapy-for-metastatic-renal-cell-carcinoma
#11
Ariel Schulman, Mathew Fakhoury, Jean P Wuilleumier, Kevin Becker, Bernadine Donahue, Ruoqing Huang, James Butler, Howard Goodman, Ervin Teper, David Silver
We present a 55-year-old male, with good performance status who was diagnosed with a case of metastatic renal cell carcinoma following a pathologic femur fracture. Despite good performance status, multifocal metastases and poor-prognostic features portended a grim prognosis with predicted overall survival of less than nine months. On initial presentation, he was excluded from cytoreductive nephrectomy based on brain metastasis and interleukin-2 was not pursued as the primary tumor was to be left in situ. The patient was reconsidered for cytoreductive nephrectomy after sustained response to fifth line targeted therapies with shrinkage of tumor burden...
January 2017: Current Urology
https://www.readbyqxmd.com/read/28411914/ablative-therapy-for-small-renal-masses
#12
REVIEW
Benjamin L Taylor, S William Stavropoulos, Thomas J Guzzo
The management of small renal masses has become an important public health topic. The increased use of cross-sectional imaging and ultrasound has led to a downward stage migration for the detection of small renal masses. Cancer-specific survival, however, has not reflected this trend accordingly. Although partial nephrectomy has been the mainstay of treatment of small renal masses less than 4 cm, there is growing interest in ablative therapies, such as cryoablation and radiofrequency ablation, due to decreased morbidity...
May 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/28408296/percutaneous-radiofrequency-ablation-for-renal-cell-carcinoma-vs-partial-nephrectomy-comparison-of-long-term-oncologic-outcomes-in-both-clear-cell-and-non-clear-cell-of-the-most-common-subtype
#13
Ning Liu, Daoguang Huang, Xiangming Cheng, Yankun Chong, Wei Wang, Weidong Gan, Hongqian Guo
OBJECTIVES: To compare the clinical outcomes of percutaneous radiofrequency ablation (PRFA) and partial nephrectomy (PN) in patients with clear cell renal cell carcinoma (ccRCC) and non-clear cell RCC (nccRCC) of the most common subtypes. MATERIALS AND METHODS: A retrospective study was conducted to review the records of all the patients who underwent PRFA or PN between February 2005 and April 2014 at our institution. Patients with histologic confirmation of ccRCC, papillary RCC, and chromophobe RCC were included...
April 10, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28405606/changes-in-markers-of-mineral-metabolism-after-living-kidney-donation
#14
Sven-Jean Tan, Tim D Hewitson, Peter D Hughes, Stephen G Holt, Nigel D Toussaint
BACKGROUND: Living kidney donors (LKDs) experience reduction in kidney function, however serum phosphate (sPi) levels are lower compared to patients with chronic kidney disease matched for reduced kidney function. Mineral metabolism adaptations that occur in LKDs have not been adequately investigated. To evaluate the effect of nephrectomy on markers of mineral metabolism in LKDs compared to healthy volunteers (HV) over 12 months. METHODS: Mineral parameters were evaluated in twenty-one adult LKDs and twenty HVs...
April 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28393204/inverse-relationship-between-insulin-receptor-expression-and-progression-in-renal-cell-carcinoma
#15
Makoto Takahashi, Takamitsu Inoue, Mingguo Huang, Kazuyuki Numakura, Hiroshi Tsuruta, Mitsuru Saito, Atsushi Maeno, Eijiro Nakamura, Shintaro Narita, Norihiko Tsuchiya, Tomonori Habuchi
We investigated the relationship among serum insulin level, insulin receptor (IR) expression in renal cell carcinoma (RCC), and outcomes in patients with RCC who underwent nephrectomy. We also explored the role of insulin signaling in RCC progression in a murine RCC allograft RENCA model using metformin to treat hyperinsulinemia induced by a high-carbohydrate diet. Clinically, the IR expression level in RCC tissue was significantly lower in patients with tumor stage pT2-4 and/or distant metastases. The IR expression level in RCC tissue was significantly lower in patients with preoperative serum C-peptide levels greater than or equal to the median than in patients with levels less than the median...
April 5, 2017: Oncology Reports
https://www.readbyqxmd.com/read/28359745/laparoscopic-cryoablation-for-renal-cell-carcinoma-100-month-oncologic-outcomes-caputo-pa-ramirez-d-zargar-h-akca-o-andrade-hs-o-malley-c-remer-em-kaouk-jh-j-urol-2015-oct-194-4-892-896-epub-2015-april-23-doi-10-1016-j-juro-2015-03-128
#16
Max Meng
PURPOSE: With the incidence of renal cell carcinoma on the rise treatment options for the small renal mass have broadened. Cryoablation is increasingly used as a therapeutic option for renal tumors in select cases. However, studies with long-term oncologic outcomes are sparse. We evaluated the long-term oncologic outcomes of laparoscopic renal mass cryoablation. MATERIALS AND METHODS: We reviewed our laparoscopic cryoablation database for patients treated with laparoscopic cryoablation from October 1997 to February 2005...
May 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28341499/renal-arteriovenous-malformations-a-rare-vascular-cause-of-back-pain
#17
Tazo Inui, David Frankel
OBJECTIVE: Renal arteriovenous malformation (AVM) is a very rare phenomenon (fewer than 200 cases in the literature), most commonly (75%) presenting with hematuria in young women. Renal AVMs may be cirsoid (multi-branched) or cavernous, with cirsoid morphology predominating 3:1. The historical treatment is partial nephrectomy. Best endovascular therapy is divided among many options. We present 2 cases of large renal AVMs treated with single Amplatzer plugs. METHODS: During a 2-year period (2014-15), 2 patients presented for vascular evaluation of renal AVMs found incidentally on workup for non-specific abdominal and back pain...
March 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28338459/comparison-of-pfannenstiel-or-extended-iliac-port-site-kidney-extraction-in-laparoscopic-donor-nephrectomy-do-we-have-consensus
#18
Paiboon Iemsupakkul, Wisoot Kongchareonsombat, Kittinut Kijvikai
OBJECTIVES: Our objective was to compare the outcomes of the different extraction sites between extended iliac port site incision and Pfannenstiel incision during laparoscopic donor nephrectomy. MATERIALS AND METHODS: We prospectively evaluated patients who underwent laparoscopic donor nephrectomy from June 2014 to March 2015 at our institution. Perioperative parameters were included, with particular reference to warm ischemic time. The other parameters recorded included operative time, blood loss, hospital stay, analgesic requirement, and cosmetic results...
April 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28314968/-when-is-cytoreductive-nephrectomy-not-beneficial-for-patients-with-metastatic-renal-cell-carcinoma
#19
Martin Schostak
Primary tumor resection in patients with synchronous metastatic renal cell carcinoma and a good performance status corresponds to a guideline recommendation which, however, is based on weak data from the era of cytokine therapy. This article presents arguments that weigh heavily against cytoreductive nephrectomy. From a molecular genetic viewpoint, the intervention eliminates only the easiest adversary but cannot prevent cancer-related death. Therefore, benefits and risks must be carefully and critically considered...
March 17, 2017: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/28299325/protective-effects-of-the-segmental-renal-artery-clamping-technique-on-ischemia-reperfusion-injury-in-db-db-diabetic-mice
#20
Chao Liang, Jundong Zhu, Chenkui Miao, Shangqian Wang, Lei Zhang, Pu Li, Zengjun Wang, Pengfei Shao
Renal ischemia-reperfusion (I/R) injury is inevitable in partial nephrectomy and other kidney surgeries, with a higher incidence in patients with renal insufficiency. This study aimed to investigate the protective effects of precise segmental renal artery clamping (SRAC) against renal I/R injury in db/db diabetic mice, compared with conventional renal artery clamping (RAC). Grape seed extract, a powerful free radical scavenger, was administered to diabetic mice for 4 weeks before operation in subgroups (30 mg/kg/d)...
2017: BioMed Research International
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