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LESS nephrectomy

Mohsin Jamal, Kanika Taneja, Sohrab Arora, Ravi Barod, Craig G Rogers, Jessica Sanchez, Nilesh S Gupta, Sean R Williamson
Occasionally, renal cell carcinoma (RCC) with renal vein extension spreads against the flow of blood within vein branches into the kidney, forming multifocal nodules throughout the renal parenchyma. These foci are not regarded as multiple tumors but rather reverse spread of tumor along the venous system. This intravascular spread has previously been reported in clear cell RCC and RCC unclassified. However, to our knowledge, this has never been reported in chromophobe RCC. Chromophobe RCC is a unique histologic subtype of renal cancer, generally thought to have less aggressive behavior...
March 1, 2018: International Journal of Surgical Pathology
Morgan K Richards, Adam B Goldin, Peter F Ehrlich, Elizabeth A Beierle, John J Doski, Melanie Goldfarb, Monica Langer, Jed G Nuchtern, Sanjeev Vasudevan, Kenneth W Gow
Standard of care for unilateral nephroblastoma includes total nephrectomy (TN) with nodal sampling. We sought to compare the outcomes of TN and partial nephrectomy (PN). We performed a retrospective cohort study of TN and PN for nephroblastoma using the National Cancer Data Base. The outcomes included nodal sampling frequency, margin status, and survival. Categorical and continuous data were evaluated with χ2 and t tests, respectively (P < 0.05). Generalized linear models evaluated nodal sampling and margin status...
March 1, 2018: American Surgeon
Pooya Banapour, George A Abdelsayed, Zoe Bider-Canfield, Peter A Elliott, Patrick S Kilday, Gary W Chien
To compare perioperative outcomes in the three most common partial nephrectomy modalities: robotic (RPN), laparoscopic (LPN), and open (OPN), matched for nephrometry scores. Patients aged 16-85 who underwent RPN, LPN, or OPN from 2007 to 2014 for localized renal carcinoma within our healthcare system were enrolled. Age, sex, body mass index, and Charlson Comorbidity Index (CCI) as well as perioperative outcomes of estimated blood loss (EBL), length of hospital stay (LOS), ischemia time (IT), change in eGFR, positive margin rate, operative time (OT), and emergency room visit rates were compared between RPN, LPN, and OPN using the R...
March 19, 2018: Journal of Robotic Surgery
Shih-Yen Lu, Hsiao-Jen Chung, Eric Yi-Hsiu Huang, Tzu-Pin Lin, Alex T L Lin
BACKGROUND: The aim of this study was to compare the perioperative outcomes between renal hilar tumors and non-hilar tumors after robotic-assisted partial nephrectomy (RAPN). METHODS: A retrospective review of consecutive patients who underwent RAPN from December 2009 to September 2015 at our institution was recruited. Perioperative outcomes including demographic characteristics, perioperative, pathological and renal function outcomes were compared between the hilar group (n = 30) and non-hilar group (n = 170)...
March 15, 2018: Journal of the Chinese Medical Association: JCMA
Safdar Shah, Abeer Fatima, Muhammad Danial Ali Shah, Wajid Ali, Irfan Ahmed Gorya, Fawad Nasrullah
A renal artery pseudoaneurysm is a rare but important complication that can occur after renal trauma, renal biopsy, percutaneous nephrostomy, percutaneous nephrolithotomy (PCNL), and partial nephrectomy. The incidence of this potentially life-threatening complication is less than 1%, but is likely to increase with the increasing popularity of endoscopic renal procedures. We present a case of a 30-year female who underwent right PCNL for a right renal pelvic stone. Two weeks later, she presented with massive hematuria...
March 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
José A Jiménez-Heffernan, Patricia Muñoz-Hernández, Alberto Canca Velasco, Alwalid Freih Fraih, Julián Cuesta, Pilar González-Peramato, Carlos Olivier-García, Blanca Vicandi
BACKGROUND: Differentiation between normal renal cellular structures and renal tumors can be a diagnostic challenge during fine needle aspiration. It is of particular relevance during percutaneous thermal ablation because of the small size of tumors and when performing rapid on-site evaluation. METHODS: A cyto-histological correlation study assisted by immunocytochemistry was performed. The study was based on 10 nephrectomy specimens. For the identification of proximal tubular cells we used CD10 and α-methylacyl coenzyme A racemase (AMACR)...
March 14, 2018: Diagnostic Cytopathology
Chalairat Suk-Ouichai, Jitao Wu, Wen Dong, Hajime Tanaka, Yanbo Wang, J J H Zhang, Elvis Caraballo, Erick Remer, Jianbo Li, Sudhir Isharwal, Steven C Campbell
OBJECTIVES: To evaluate contact surface area (CSA) between the tumor and parenchyma as a predictor of ipsilateral parenchyma and function preserved after partial nephrectomy (PN). Previous studies suggested that CSA is a strong predictor of functional outcomes but the limitations of CSA have not been adequately explored. PATIENTS/METHODS: 419 patients managed with standard PN for solitary tumor with necessary studies to evaluate ipsilateral preoperative/postoperative parenchymal mass/function were analyzed...
March 6, 2018: Urology
Adam Lang, Louis P Dehner
INTRODUCTION: Clear cell sarcoma of the kidney (CCSK) is childhood neoplasm with its own distinctive pattern of metastasis and may appear after a disease free interval of 5 years or more. MATERIALS AND METHODS: Histopathology and immunohistochemistry were available from the radical nephrectomy and the later partial cystectomy, which was performed after a seven disease-free interval. RESULTS: The pathologic features of the primary tumor were those of a classic CCSK with a monotypic pattern of uniform rounded to ovoid tumor cells with a background network of delicate blood vessels...
March 6, 2018: Fetal and Pediatric Pathology
Francisco Miguel Sánchez-Margallo, Juan A Sánchez-Margallo
PURPOSE: New laparoscopic devices are being continuously developed to overcome some of the technical and ergonomic limitations of laparoendoscopic single-site (LESS) surgery. This study aims to assess the surgeon's surgical performance and ergonomics during the use of a handheld, robotic-driven, articulating laparoscopic instrument during LESS surgery. METHODS: Seven right-handed experienced surgeons took part in this study. A set of basic suturing tasks and digestive and urological procedures in a porcine model were performed...
February 1, 2018: Surgical Innovation
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
Vusal Ahmedov, Fuat Kizilay, Ibrahim Cüreklibatir
PURPOSE: In this retrospective study, we aimed to investigate the prognostic effect of body mass index (BMI) in localized renal cell carcinoma (RCC) cases who underwent surgical treatment. Furthermore, the assessment of various patient and tumor characteristics and surgical methods on survival has been identified as additional targets. MATERIALS AND METHODS: Three hundred and eighty patients with localised, non-metastatic, unilateral RCC who underwent radical or partial nephrectomy in our clinic between January 2007 and December 2016 were enrolled in this study...
February 18, 2018: Urology Journal
Steven M Monda, Jonathan R Weese, Barrett G Anderson, Joel M Vetter, Ramakrishna Venkatesh, Kefu Du, Gerald L Andriole, Robert S Figenshau
OBJECTIVE: To provide a training tool to address the technical challenges of robot-assisted laparoscopic partial nephrectomy, we created silicone renal tumor models using 3-dimensional printed molds of a patient's kidney with a mass. In this study, we assessed the face, content, and construct validity of these models. MATERIALS AND METHODS: Surgeons of different training levels completed 4 simulations on silicone renal tumor models. Participants were surveyed on the usefulness and realism of the model as a training tool...
February 5, 2018: Urology
Siddharth Jain, Sudhir K Jain, Ram C M Kaza, Yashasvi Singh
In prospective study from November 2011- November 2013, we performed 44 laparoscopic nephrectomies for benign non-functioning kidney diseases. Twenty eight patients underwent laparoscopic transperitoneal nephrectomies (63.6%), ten were laparoscopic assisted (22.7%) and six (13.6%) were converted to open. Patient's age, gender, laterality and etiology of renal failure were noted. Outcomes were measured as operative time, intraoperative and post operative complications, blood loss, pain score and hospital stay...
January 2018: Urology Annals
Kyu Won Lee, Sae Woong Choi, Yong Hyun Park, Woong Jin Bae, Yong Sun Choi, U-Syn Ha, Sung-Hoo Hong, Ji Youl Lee, Sae Woong Kim, Hyuk Jin Cho
PURPOSE: To compare the clinical outcomes of laparoendoscopic single-site plus one-port donor nephrectomy (LESSOP-DN) and mini laparoscopic donor nephrectomy (MLDN). METHODS: A prospective randomized controlled trial was conducted from December 2014 to February 2016 in donors scheduled for left donor nephrectomy. Donor and recipient demographics and clinical outcomes including pain scores and questionnaires (BIQ: body image questionnaire, SF-36, patient-reported overall convalescence) were also compared...
February 2, 2018: World Journal of Urology
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
Jennifer M Burg, David L Scott, Kayvan Roayaie, Erin Maynard, John M Barry, C Kristian Enestvedt
Reports for pediatric kidney transplant recipients suggested better outcomes for ODN compared to LDN. Contemporary outcomes stratified by donor type and center volume have not been evaluated in a national dataset. UNOS data (2000-2014) were analyzed for pediatric living donor kidney transplant recipients. The primary outcome was GF; secondary outcomes were DGF, rejection, and patient survival. Live donor nephrectomies for pediatric recipients decreased 30% and transitioned from ODN to LDN. GF rates did not differ for ODN vs LDN (P = ...
February 2, 2018: Pediatric Transplantation
Diogo Alpuim Costa, Susana Baptista de Almeida, Pedro Coelho Barata, António Quintela, Pedro Cabral, Ana Afonso, João Maia Silva
In phase II/III trials, cutaneous side effects of pazopanib were reported in less than 20% of patients, with only 1-3% being grade 3/4. We present a case of a 66-year-old man with a previous history of left nephrectomy for a stage II clear cell renal carcinoma. Approximately 18 months later, recurrent disease in the lungs, mediastinum, and left psoas and bulky abdominal/pelvic nodal metastasis were documented. He was initially treated with pazopanib 800 mg q.d. and 1 week after starting this therapy, the patient presented with palpable purpura on his ankles...
September 2017: Case Reports in Oncology
Paolo Capogrosso, Alessandro Larcher, Daniel D Sjoberg, Emily A Vertosick, Francesco Cianflone, Paolo Dell'Oglio, Cristina Carenzi, Andrea Salonia, Andrew J Vickers, Francesco Montorsi, Roberto Bertini, Umberto Capitanio
PURPOSE: To assess the accuracy of the University of California Los Angeles integrated staging system (UISS) in predicting postoperative recurrence of RCC, and to evaluate whether including patient age and tumor histology may improve clinical decision-making. MATERIALS AND METHODS: Analyses were performed for 1,630 patients treated with nephrectomy at a single academic center. The accuracy of the UISS model to predict early (<=12 months) and late (>60 months) recurrence after surgery was compared with a new model that includes patient age and disease histology...
January 22, 2018: Journal of Urology
Mahmoud Alameddine, Tulay Koru-Sengul, Kevin J Moore, Feng Miao, Luís Felipe Sávio, Bruno Nahar, Nachiketh Soodana Prakash, Vivek Venkatramani, Joshua S Jue, Sanoj Punnen, Dipen J Parekh, Chad R Ritch, Mark L Gonzalgo
BACKGROUND: Partial nephrectomy is widely used for surgical management of small renal masses. Use of robotic (RPN) versus open partial nephrectomy (OPN) among various populations is not well characterized. OBJECTIVE: To analyze trends in utilization of RPN and disparities that may be associated with this procedure for management of cT1 renal masses in the USA. DESIGN, SETTING, AND PARTICIPANTS: Patients who underwent RPN or OPN for clinical stage T1N0M0 renal masses in the USA from 2010 to 2013 were identified in the National Cancer Data Base...
January 8, 2018: European Urology Focus
T T Zha, Z Y Xing, J Chen, W Xing, J G Zhang, X J Tian
Objective: To investigate the feasibility of blood oxygen level-dependent MR (MR-BOLD) in assessing renal fibrosis of ureteral obstruction of rabbits. Methods: Forty healthy New Zealand rabbits were randomly divided into control group (n=8) and unilateral ureteral obstruction (UUO) group (n=32). The rabbits in the UUO group were subjected to unilateral ureteral obstruction of the left kidney.Coronal T(2) weighted imaging (T(2)WI) and axial BOLD examinations were performed before operation, 2, 4, 6 and 8 W after operation (each subgroup n=8)...
December 19, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
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