Search results for "partial nephrectomy"
showing 10 items of 11 documents
Risk Assessment for Complications of Partial Nephrectomy – Comparative Study between Retroperitoneoscopic Approach and Open Surgery
2017
Introduction. Partial nephrectomy represent the standard of care for small renal tumor. Laproscopic approach tends to replace open surgery due to similar oncologic results, but with better eastethic outcomes and earlier socio-professional reintegration. Material and methods. Between January 2010 and February 2017, 55 patients (p) underwent partial nephrectomy at our center for clinically localized renal tumor, 21p with LPN by retroperitoneal approach and 34p with OPN. All patients had a normal contralateral kidney. The selection of patients for nephron-sparing surgery was based on preoperative CT scan, location of the tumor, the individual general health status of the patient and individual…
Transperitoneal vs retroperitoneal minimally invasive partial nephrectomy: comparison of perioperative outcomes and functional follow-up in a large m…
2020
Abstract Background Aim of this study was to evaluate and compare perioperative outcomes of transperitoneal (TP) and retroperitoneal (TR) approaches in a multi-institutional cohort of minimally invasive partial nephrectomy (MI-PN). Material and methods All consecutive patients undergone MI-PN for clinical T1 renal tumors at 26 Italian centers (RECORd2 project) between 01/2013 and 12/2016 were evaluated, collecting the pre-, intra-, and postoperative data. The patients were then stratified according to the surgical approach, TP or RP. A 1:1 propensity score (PS) matching was performed to obtain homogeneous cohorts, considering the age, gender, baseline eGFR, surgical indication, clinical dia…
Open Radical Nephrectomy: 35 Years of Experience at the “Luciano Giuliani” Urological Department of the University of Genoa
2006
Objective: Radical nephrectomy remains the gold standard for surgically resectable kidney neoplasms > 4 cm and, in selected cases, also in presence of metastatic disease. We reviewed the records of the patients having surgery at the University of Genoa in the last 35 yr. Methods: We have retrospectively assessed all the radical nephrectomies performed between 1970 and 2005. Among tumours of the kidney subjected to surgical treatment during this period, we found 1105 cases of histologically proven renal cell carcinoma (RCC), 965 of which had records available for the study. The number of cases per year, symptoms at diagnosis, surgical strategy, staging of the tumour, and survival were rev…
Absolok® versus Hem-o-Lok® clips for renorrhaphy during partial nephrectomy for parenchymal renal tumors
2020
Background To compare perioperative and functional outcomes associated with renorrhaphy performed with two different types of clips (Absolok® vs. Hem-o-Lok®) in a contemporary series of patients who underwent partial nephrectomy. Methods Patients in whom Absolok® clips were used to perform haemostasis at the level of tumor bed or to block the running sutures during sliding-clip renorrhaphy (study group) were compared with a contemporary control group of patients in whom renorrhaphy was performed with Hem-o-Lok® clips. Both groups received the same surgical technique via an open or robot-assisted approach. Inner renorrhaphy was performed with one or more 3-0 (26 mm needle) monofilament runni…
Pringle maneuver during open partial nephrectomy for renal tumors
2017
Introduction. Sparing kidney tissue is important because studies show that patients who have their entire kidney removed are more likely to suffer from chronic kidney disease after surgery than patients who received a kidney-sparing partial nephrectomy. The aim of study is to show the effectives of Pringle maneuver for clamping renal pedicle in order to minimize warm ischemia during open partial nephrectomy. Material and method. We retrospectively analyzed 34 patients diagnosed with cT1 renal tumors between 2012 and 2016 and underwent open partial nephrectomy in Sibiu Urology Department. During the surgery we perform clamping of renal pedicle with Satinsky clamp or with the Pringle maneuver…
Clinical implications of a rare renal entity: Pleomorphic Hyalinizing Angiectatic Tumor (PHAT)
2017
Abstract Pleomorphic Hyalinizing Angiectatic Tumor (PHAT) is a rare benign lesion characterized by slow growth, infiltrative behavior and high rate of local recurrences. Only one case has been described in retroperitoneum, at renal hilum, but not involving pelvis or parenchyma. Here we present the first case of PHAT arising in the renal parenchyma. A nodular lesion in right kidney lower pole was diagnosed to a 61 year old woman. The patient underwent right nephrectomy. Microscopically, the lesion showed solid and pseudo-cystic components with hemorrhagic areas characterized by aggregates of ectatic blood vessels. Pleomorphic cells were characterized by large eosinophilic cytoplasm with irre…
Predicting positive surgical margins in partial nephrectomy: A prospective multicentre observational study (the RECORd 2 project)
2020
PURPOSE: to evaluate clinical predictors of positive surgical margins (PSMs) in a large multicenter prospective observational study and to develop a clinic nomogram to predict the likelihood of PSMs after partial nephrectomy (PN). MATERIALS AND METHODS: We prospectively evaluated 4308 patients who had surgical treatment for renal tumors between January 2013 and December 2016 at 26 urological Italian Centers (RECORd 2 project). Two multivariable logistic models were evaluated to predict the likelihood of PSMs. Center caseload was dichotomized using a visual assessment adjusted for several predictors of PSMs. A nomogram predicting PSMs was developed. RESULTS: Overall, 2076 patients treated wi…
Concise report on renal sparing surgery in the treatment of renal cell carcinoma. The guide for non- urologists
2019
Przedstawiono aktualne podejście chirurgiczne do leczenia raka nerki. Omówiono zalety chirurgii oszczędzającej nefron, z naciskiem na rosnące wykorzystanie tej techniki w praktyce klinicznej. Porównano także konkretne warianty operacji oszczędzającej nefron, tj. laparoskopowej i robotycznej.
Elective partial nephrectomy is equivalent to radical nephrectomy in patients with clinical T1 renal cell carcinoma: results of a retrospective, comp…
2012
Study Type - Therapy (cohort) Level of Evidence 2b What's known on the subject? and What does the study add? Few studies supported the expanded indications for nephron-sparing surgery (NSS) in selected patients with 4.1 cm renal tumours in the size range (T1b). However, all these comparative studies included both imperative and elective partial nephrectomy and patient selection for analysis was based on pathological stage (pT1) and not on clinical stage (cT1). Patients with clinically organ-confined RCC (cT1) who are candidates for elective PN have a limited risk of clinical understaging. NSS is not associated with an increased risk of recurrence and cancer-specific mortality both in cT1a a…
Cost-effectiveness analysis of robot-assisted vs. open partial nephrectomy
2017
Background The cost-effectiveness of robot-assisted partial nephrectomy (RAPN) vs. the open procedure is not established. Methods We estimated in-hospital complications and the cost of RAPN vs. open partial nephrectomy (OPN) using an economic model. Costs incurred both intraoperatively and in hospital were considered. US data were extracted from existing literature. Results Mean in-hospital costs were $14,824 (95% CI $13,368-$16,898) for RAPN and $15,094 (95% CI $13,491-$17,140) for OPN. Complications after RAPN occurred in 23.3% (95% CI 20.0-25.8%) and after OPN in 36.1% (95% CI 35.6-36.6%) of the patients. In a sensitivity analysis, limited centre experience was associated with relevant i…