Off-clamp robotic-assisted partial nephrectomy: surgical experience from a single centre
INTRODUCTION: Robot-assisted partial nephrectomy (RAPN) is a minimally invasive treatment for localized renal tumours, which can sometimes result in extended warm ischaemic time and serious complications. This study reports on surgical outcomes including feasibility, positive margins, and complicati...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Polish Urological Association
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10357834/ https://www.ncbi.nlm.nih.gov/pubmed/37483857 http://dx.doi.org/10.5173/ceju.2023.261 |
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author | Zanoni, Matteo Grizzi, Fabio Vota, Paolo Toia, Giovanni Mazzieri, Cinzia Clementi, Maria Chiara Beatrici, Edoardo Taverna, Gianluigi |
author_facet | Zanoni, Matteo Grizzi, Fabio Vota, Paolo Toia, Giovanni Mazzieri, Cinzia Clementi, Maria Chiara Beatrici, Edoardo Taverna, Gianluigi |
author_sort | Zanoni, Matteo |
collection | PubMed |
description | INTRODUCTION: Robot-assisted partial nephrectomy (RAPN) is a minimally invasive treatment for localized renal tumours, which can sometimes result in extended warm ischaemic time and serious complications. This study reports on surgical outcomes including feasibility, positive margins, and complications during and after surgery. MATERIAL AND METHODS: From January 2011 to November 2022, a single centre performed off-clamp sutureless RAPN on 287 patients. The study recorded preoperative patient characteristics, estimated glomerular filtration rate, and tumour features according to the preoperative aspects and dimensions used for an anatomical (PADUA) classification, and utilized the RENAL nephrometry scoring system. Intraoperative details and complications were documented. Postoperative complications within 30 days were classified according to the Clavien-Dindo system. Follow-up appointments were scheduled at 1, 3, and 6 months in the first year, followed by subsequent appointments every 6 months, and then annually. RESULTS: The study included 145 males and 142 females, with a mean age of 58.9 years and a mean body mass index of 26.7 kg/m(2). The mean PADUA score was 8.3, the average console time was 83 minutes, and the estimated blood loss was 280 mL. The average hospital stay was 3 days, and no intraoperative complications were observed. However, 4 patients (1.4%) experienced post-operative haemorrhage that required laparotomy (Clavien-Dindo stage IIIB), and 4 patients (1.4%) had positive surgical margins. CONCLUSIONS: Off-clamp selective arterial clamping during minimally invasive partial nephrectomy is a safe and feasible approach for small renal tumours. Further randomized prospective studies are required to confirm if RAPN without clamping offers any renal functional benefits and reduces perioperative bleeding complications. |
format | Online Article Text |
id | pubmed-10357834 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Polish Urological Association |
record_format | MEDLINE/PubMed |
spelling | pubmed-103578342023-07-21 Off-clamp robotic-assisted partial nephrectomy: surgical experience from a single centre Zanoni, Matteo Grizzi, Fabio Vota, Paolo Toia, Giovanni Mazzieri, Cinzia Clementi, Maria Chiara Beatrici, Edoardo Taverna, Gianluigi Cent European J Urol Original Paper INTRODUCTION: Robot-assisted partial nephrectomy (RAPN) is a minimally invasive treatment for localized renal tumours, which can sometimes result in extended warm ischaemic time and serious complications. This study reports on surgical outcomes including feasibility, positive margins, and complications during and after surgery. MATERIAL AND METHODS: From January 2011 to November 2022, a single centre performed off-clamp sutureless RAPN on 287 patients. The study recorded preoperative patient characteristics, estimated glomerular filtration rate, and tumour features according to the preoperative aspects and dimensions used for an anatomical (PADUA) classification, and utilized the RENAL nephrometry scoring system. Intraoperative details and complications were documented. Postoperative complications within 30 days were classified according to the Clavien-Dindo system. Follow-up appointments were scheduled at 1, 3, and 6 months in the first year, followed by subsequent appointments every 6 months, and then annually. RESULTS: The study included 145 males and 142 females, with a mean age of 58.9 years and a mean body mass index of 26.7 kg/m(2). The mean PADUA score was 8.3, the average console time was 83 minutes, and the estimated blood loss was 280 mL. The average hospital stay was 3 days, and no intraoperative complications were observed. However, 4 patients (1.4%) experienced post-operative haemorrhage that required laparotomy (Clavien-Dindo stage IIIB), and 4 patients (1.4%) had positive surgical margins. CONCLUSIONS: Off-clamp selective arterial clamping during minimally invasive partial nephrectomy is a safe and feasible approach for small renal tumours. Further randomized prospective studies are required to confirm if RAPN without clamping offers any renal functional benefits and reduces perioperative bleeding complications. Polish Urological Association 2023-05-05 2023 /pmc/articles/PMC10357834/ /pubmed/37483857 http://dx.doi.org/10.5173/ceju.2023.261 Text en Copyright by Polish Urological Association https://creativecommons.org/licenses/by-nc-sa/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license. |
spellingShingle | Original Paper Zanoni, Matteo Grizzi, Fabio Vota, Paolo Toia, Giovanni Mazzieri, Cinzia Clementi, Maria Chiara Beatrici, Edoardo Taverna, Gianluigi Off-clamp robotic-assisted partial nephrectomy: surgical experience from a single centre |
title | Off-clamp robotic-assisted partial nephrectomy: surgical experience from a single centre |
title_full | Off-clamp robotic-assisted partial nephrectomy: surgical experience from a single centre |
title_fullStr | Off-clamp robotic-assisted partial nephrectomy: surgical experience from a single centre |
title_full_unstemmed | Off-clamp robotic-assisted partial nephrectomy: surgical experience from a single centre |
title_short | Off-clamp robotic-assisted partial nephrectomy: surgical experience from a single centre |
title_sort | off-clamp robotic-assisted partial nephrectomy: surgical experience from a single centre |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10357834/ https://www.ncbi.nlm.nih.gov/pubmed/37483857 http://dx.doi.org/10.5173/ceju.2023.261 |
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