Cargando…

Long-Term Oncological and Functional Outcomes after Laparoscopic Partial Nephrectomy with Hyperselective Embolization of Tumor Vessels in a Hybrid Operating Room

Laparoscopic partial nephrectomy (LPN) after hyperselective embolization of tumor vessels (HETV) in a hybrid operating room (HOR) that combines traditional surgical equipment with advanced imaging technology, is a non-clamping surgical approach to treat localized kidney tumors that has shown promisi...

Descripción completa

Detalles Bibliográficos
Autores principales: Frantz, Ulysse, Bouvier, Antoine, Culty, Thibaut, Zidane, Merzouka, Lebdai, Souhil, Bigot, Pierre
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10455466/
https://www.ncbi.nlm.nih.gov/pubmed/37629209
http://dx.doi.org/10.3390/jcm12165167
_version_ 1785096457981788160
author Frantz, Ulysse
Bouvier, Antoine
Culty, Thibaut
Zidane, Merzouka
Lebdai, Souhil
Bigot, Pierre
author_facet Frantz, Ulysse
Bouvier, Antoine
Culty, Thibaut
Zidane, Merzouka
Lebdai, Souhil
Bigot, Pierre
author_sort Frantz, Ulysse
collection PubMed
description Laparoscopic partial nephrectomy (LPN) after hyperselective embolization of tumor vessels (HETV) in a hybrid operating room (HOR) that combines traditional surgical equipment with advanced imaging technology, is a non-clamping surgical approach to treat localized kidney tumors that has shown promising short-term results. The aim of this study was to evaluate the long-term oncological and functional outcomes of this procedure. All consecutive patients treated for a localized kidney tumor by LPN after HETV between May 2015 and October 2022 in a single academic institution were included in the study. Clinical, pathological and biological data were collected prospectively in the uroCCR database. We evaluated intraoperative data, postoperative complications, surgical margin and modification of renal function after surgery. We included 245 patients. The median tumor size was 3.2 (2.5–4.4) cm. The R.E.N.A.L. complexity was low, medium and high for 104 (43.5%), 109 (45.6%) and 26 (10.9%) patients, respectively. Median LPN time was 75 (65–100) min and median blood loss was 100 (50–300) mL. Surgical postoperative complications occurred in 56 (22.9%) patients with 17 (5.7%) major complications. The median Glomerular Function Rate variation at 6 months was −7.5 (−15–−2) mL/min. Malignant tumors were present in 211 (86.1%) patients, and 12 (4.9%) patients had positive surgical margins. After a median follow-up of 27 (8–49) months, 20 (8.2%) patients had a tumor recurrence and 4 (1.6%) died from cancer. At 5 years, disease free survival, cancer specific survival and overall survival rates were 84%, 96.8% and 88.3%, respectively. Performing LPN after HETV in a HOR is a safe and efficient non-clamping approach to treat localized kidney tumors.
format Online
Article
Text
id pubmed-10455466
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-104554662023-08-26 Long-Term Oncological and Functional Outcomes after Laparoscopic Partial Nephrectomy with Hyperselective Embolization of Tumor Vessels in a Hybrid Operating Room Frantz, Ulysse Bouvier, Antoine Culty, Thibaut Zidane, Merzouka Lebdai, Souhil Bigot, Pierre J Clin Med Article Laparoscopic partial nephrectomy (LPN) after hyperselective embolization of tumor vessels (HETV) in a hybrid operating room (HOR) that combines traditional surgical equipment with advanced imaging technology, is a non-clamping surgical approach to treat localized kidney tumors that has shown promising short-term results. The aim of this study was to evaluate the long-term oncological and functional outcomes of this procedure. All consecutive patients treated for a localized kidney tumor by LPN after HETV between May 2015 and October 2022 in a single academic institution were included in the study. Clinical, pathological and biological data were collected prospectively in the uroCCR database. We evaluated intraoperative data, postoperative complications, surgical margin and modification of renal function after surgery. We included 245 patients. The median tumor size was 3.2 (2.5–4.4) cm. The R.E.N.A.L. complexity was low, medium and high for 104 (43.5%), 109 (45.6%) and 26 (10.9%) patients, respectively. Median LPN time was 75 (65–100) min and median blood loss was 100 (50–300) mL. Surgical postoperative complications occurred in 56 (22.9%) patients with 17 (5.7%) major complications. The median Glomerular Function Rate variation at 6 months was −7.5 (−15–−2) mL/min. Malignant tumors were present in 211 (86.1%) patients, and 12 (4.9%) patients had positive surgical margins. After a median follow-up of 27 (8–49) months, 20 (8.2%) patients had a tumor recurrence and 4 (1.6%) died from cancer. At 5 years, disease free survival, cancer specific survival and overall survival rates were 84%, 96.8% and 88.3%, respectively. Performing LPN after HETV in a HOR is a safe and efficient non-clamping approach to treat localized kidney tumors. MDPI 2023-08-08 /pmc/articles/PMC10455466/ /pubmed/37629209 http://dx.doi.org/10.3390/jcm12165167 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Frantz, Ulysse
Bouvier, Antoine
Culty, Thibaut
Zidane, Merzouka
Lebdai, Souhil
Bigot, Pierre
Long-Term Oncological and Functional Outcomes after Laparoscopic Partial Nephrectomy with Hyperselective Embolization of Tumor Vessels in a Hybrid Operating Room
title Long-Term Oncological and Functional Outcomes after Laparoscopic Partial Nephrectomy with Hyperselective Embolization of Tumor Vessels in a Hybrid Operating Room
title_full Long-Term Oncological and Functional Outcomes after Laparoscopic Partial Nephrectomy with Hyperselective Embolization of Tumor Vessels in a Hybrid Operating Room
title_fullStr Long-Term Oncological and Functional Outcomes after Laparoscopic Partial Nephrectomy with Hyperselective Embolization of Tumor Vessels in a Hybrid Operating Room
title_full_unstemmed Long-Term Oncological and Functional Outcomes after Laparoscopic Partial Nephrectomy with Hyperselective Embolization of Tumor Vessels in a Hybrid Operating Room
title_short Long-Term Oncological and Functional Outcomes after Laparoscopic Partial Nephrectomy with Hyperselective Embolization of Tumor Vessels in a Hybrid Operating Room
title_sort long-term oncological and functional outcomes after laparoscopic partial nephrectomy with hyperselective embolization of tumor vessels in a hybrid operating room
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10455466/
https://www.ncbi.nlm.nih.gov/pubmed/37629209
http://dx.doi.org/10.3390/jcm12165167
work_keys_str_mv AT frantzulysse longtermoncologicalandfunctionaloutcomesafterlaparoscopicpartialnephrectomywithhyperselectiveembolizationoftumorvesselsinahybridoperatingroom
AT bouvierantoine longtermoncologicalandfunctionaloutcomesafterlaparoscopicpartialnephrectomywithhyperselectiveembolizationoftumorvesselsinahybridoperatingroom
AT cultythibaut longtermoncologicalandfunctionaloutcomesafterlaparoscopicpartialnephrectomywithhyperselectiveembolizationoftumorvesselsinahybridoperatingroom
AT zidanemerzouka longtermoncologicalandfunctionaloutcomesafterlaparoscopicpartialnephrectomywithhyperselectiveembolizationoftumorvesselsinahybridoperatingroom
AT lebdaisouhil longtermoncologicalandfunctionaloutcomesafterlaparoscopicpartialnephrectomywithhyperselectiveembolizationoftumorvesselsinahybridoperatingroom
AT bigotpierre longtermoncologicalandfunctionaloutcomesafterlaparoscopicpartialnephrectomywithhyperselectiveembolizationoftumorvesselsinahybridoperatingroom