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Nefrectomia Parcial

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9 papers 0 to 25 followers
Daniel Ramirez, Peter A Caputo, Jayram Krishnan, Homayoun Zargar, Jihad H Kaouk
OBJECTIVES: To outline our step-by-step technique for intracorporeal renal cooling during robot-assisted partial nephrectomy (RAPN). PATIENTS AND METHODS: Patient selection was performed during a preoperative clinic visit. Cases where we estimated during preoperative assessment that warm ischaemia time would be >30 min, as determined by whether the patient had a complex renal mass, were selected. The special equipment required for this procedure includes an Ecolab Hush Slush machine (Microtek Medical Inc...
March 2016: BJU International
Tobias Klatte, Vincenzo Ficarra, Christian Gratzke, Jihad Kaouk, Alexander Kutikov, Veronica Macchi, Alexandre Mottrie, Francesco Porpiglia, James Porter, Craig G Rogers, Paul Russo, R Houston Thompson, Robert G Uzzo, Christopher G Wood, Inderbir S Gill
CONTEXT: A detailed understanding of renal surgical anatomy is necessary to optimize preoperative planning and operative technique and provide a basis for improved outcomes. OBJECTIVE: To evaluate the literature regarding pertinent surgical anatomy of the kidney and related structures, nephrometry scoring systems, and current surgical strategies for partial nephrectomy (PN). EVIDENCE ACQUISITION: A literature review was conducted. EVIDENCE SYNTHESIS: Surgical renal anatomy fundamentally impacts PN surgery...
December 2015: European Urology
Alessandro Volpe, Michael L Blute, Vincenzo Ficarra, Inderbir S Gill, Alexander Kutikov, Francesco Porpiglia, Craig Rogers, Karim A Touijer, Hendrik Van Poppel, R Houston Thompson
CONTEXT: Partial nephrectomy (PN) is the current gold standard treatment for small localized renal tumors.; however, the impact of duration and type of intraoperative ischemia on renal function (RF) after PN is a subject of significant debate. OBJECTIVE: To review the current evidence on the relationship of intraoperative ischemia and RF after PN. EVIDENCE ACQUISITION: A review of English-language publications on renal ischemia and RF after PN was performed from 2005 to 2014 using the Medline, Embase, and Web of Science databases...
July 2015: European Urology
R Houston Thompson, Tom Atwell, Grant Schmit, Christine M Lohse, A Nicholas Kurup, Adam Weisbrod, Sarah P Psutka, Suzanne B Stewart, Matthew R Callstrom, John C Cheville, Stephen A Boorjian, Bradley C Leibovich
BACKGROUND: Partial nephrectomy (PN) is a preferred treatment for cT1 renal masses, whereas thermal ablation represents an alternative nephron-sparing option, albeit with higher reported rates of recurrence. OBJECTIVE: To review our experience with PN, percutaneous radiofrequency ablation (RFA), and percutaneous cryoablation for cT1 renal masses. DESIGN, SETTING, AND PARTICIPANTS: A total of 1803 patients with primary cT1N0M0 renal masses treated between 2000 and 2011 were identified from the prospectively maintained Mayo Clinic Renal Tumor Registry...
February 2015: European Urology
Jim C Hu, Eric Treat, Christopher P Filson, Ian McLaren, Siwei Xiong, Sevan Stepanian, Khaled S Hafez, Alon Z Weizer, James Porter
BACKGROUND: Robot-assisted retroperitoneoscopic partial nephrectomy (RARPN) may be used for posterior renal masses or with prior abdominal surgery; however, there is relatively less familiarity with RARPN. OBJECTIVE: To demonstrate RARPN technique and outcomes. DESIGN, SETTING, AND PARTICIPANTS: A retrospective multicenter study of 227 consecutive RARPNs was performed at the Swedish Medical Center, the University of Michigan, and the University of California, Los Angeles, from 2006 to 2013...
September 2014: European Urology
Mihir M Desai, Andre Luis de Castro Abreu, Scott Leslie, Jei Cai, Eric Yi-Hsiu Huang, Pierre-Marie Lewandowski, Dennis Lee, Arjuna Dharmaraja, Andre K Berger, Alvin Goh, Osamu Ukimura, Monish Aron, Inderbir S Gill
BACKGROUND: Concerns have been raised regarding partial nephrectomy (PN) techniques that do not occlude the main renal artery. OBJECTIVE: Compare the perioperative outcomes of superselective versus main renal artery control during robotic PN. DESIGN, SETTING, AND PARTICIPANTS: A retrospective analysis of 121 consecutive patients undergoing robotic PN using superselective control (group 1, n=58) or main artery clamping (group 2, n=63). INTERVENTION: Group 1 underwent tumor-specific devascularization, maintaining ongoing arterial perfusion to the renal remnant at all times...
October 2014: European Urology
Tobias Klatte, Shahrokh F Shariat, Mesut Remzi
PURPOSE: For the minimally invasive treatment of small renal tumors, laparoscopic cryoablation has emerged as an alternative procedure to minimally invasive partial nephrectomy (laparoscopic, robot-assisted laparoscopic) for selected patients, but there are still limited data regarding its safety and oncologic efficacy. We compare perioperative and oncologic outcomes of laparoscopic cryoablation and laparoscopic partial nephrectomy/robot-assisted laparoscopic partial nephrectomy. MATERIALS AND METHODS: We searched the literature published until September 2013 from MEDLINE®, Web of Science® and major conference proceedings...
May 2014: Journal of Urology
Haruyuki Takaki, Norihito Soga, Hideki Kanda, Atsuhiro Nakatsuka, Junji Uraki, Masashi Fujimori, Takashi Yamanaka, Takaaki Hasegawa, Kiminobu Arima, Yoshiki Sugimura, Hajime Sakuma, Koichiro Yamakado
PURPOSE: To compare clinical outcomes of radiofrequency (RF) ablation retrospectively with those after radical nephrectomy in patients with stage T1b renal cell carcinoma (RCC). MATERIALS AND METHODS: This retrospective study was approved by the institutional review board, and the requirement to obtain written informed consent was waived. From June 2002 to March 2012, 60 patients (mean age, 65.2 years; age range, 39-86 years) with a single RCC measuring 4.1-7.0 cm (stage T1b) underwent RF ablation (n = 21) or radical nephrectomy (n = 39)...
January 2014: Radiology
Emil Scosyrev, Edward M Messing, Richard Sylvester, Steven Campbell, Hendrik Van Poppel
BACKGROUND: In the European Organization for Research and Treatment of Cancer (EORTC) randomized trial 30904, nephron-sparing surgery (NSS) was associated with reduced overall survival compared with radical nephrectomy (RN) over a median follow-up of 9.3 yr (hazard ratio: 1.50; 95% confidence interval [CI], 1.03-2.16). OBJECTIVE: To examine the impact of NSS relative to RN on kidney function in EORTC 30904. DESIGN, SETTING, AND PARTICIPANTS: This phase 3 international randomized trial was conducted in patients with a small (≤5 cm) renal mass and normal contralateral kidney who were enrolled from March 1992 to January 2003...
February 2014: European Urology
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