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Role Of Robot-Assisted Partial Nephrectomy For Renal Cell Carcinomas In The Purpose Of Nephron Sparing

INTRODUCTION: Surgery remains the standard treatment for localized renal cell carcinomas, and partial nephrectomy is considered before radical nephrectomy with the aim of preserving renal function. This study aimed to compare robot-assisted and open partial nephrectomy for the purpose of nephron spa...

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Autores principales: Shao, I-Hung, Kan, Hung-Cheng, Liu, Chung-Yi, Lin, Po-Hung, Yu, Kai-Jie, Pang, See-Tong, Wu, Chun-Te, Chuang, Cheng-Keng, Chang, Ying-Hsu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6781943/
https://www.ncbi.nlm.nih.gov/pubmed/31632069
http://dx.doi.org/10.2147/OTT.S214060
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author Shao, I-Hung
Kan, Hung-Cheng
Liu, Chung-Yi
Lin, Po-Hung
Yu, Kai-Jie
Pang, See-Tong
Wu, Chun-Te
Chuang, Cheng-Keng
Chang, Ying-Hsu
author_facet Shao, I-Hung
Kan, Hung-Cheng
Liu, Chung-Yi
Lin, Po-Hung
Yu, Kai-Jie
Pang, See-Tong
Wu, Chun-Te
Chuang, Cheng-Keng
Chang, Ying-Hsu
author_sort Shao, I-Hung
collection PubMed
description INTRODUCTION: Surgery remains the standard treatment for localized renal cell carcinomas, and partial nephrectomy is considered before radical nephrectomy with the aim of preserving renal function. This study aimed to compare robot-assisted and open partial nephrectomy for the purpose of nephron sparing. MATERIALS AND METHODS: We retrospectively enrolled consecutive patients who received partial nephrectomy at a single tertiary medical center from January 2008 to January 2015. Medical records and radiographic images were reviewed. We analyzed the patients’ general characteristics, underlying disease, complications, length of hospital stay, renal tumor complexity, surgery type, renal function, and specimen and tumor size. A comparison between open and robot-assisted nephrectomy groups was performed. RESULTS: A total of 136 patients were enrolled, with a male to female ratio of 2:3 and a mean age of 57.8 years. Of these, 71 and 65 patients received open and robot-assisted surgery, respectively. Compared with the open group, patients who underwent robot-assisted surgery were significantly younger (56.0 versus 60.1 years old), had a longer operative time (303 versus 224 min), and a lower kidney ischemic time (33.4 versus 46.9 min). Given similar tumor sizes, the tumor-to-excision ratio was significantly higher in the robot-assisted group (51.7% versus 39.8%), and the excisional volume loss (EVL) was smaller (12.7 versus 19.6 mL). Preoperative glomerular filtration rate and EVL were significant predictors of long-term renal function preservation in the multivariate analysis. CONCLUSION: When performing partial nephrectomy, a robot-assisted procedure could increase the accuracy of excision without increasing the risk of positive surgical margin. Lower EVL could assist in better long-term postoperative renal function preservation.
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spelling pubmed-67819432019-10-18 Role Of Robot-Assisted Partial Nephrectomy For Renal Cell Carcinomas In The Purpose Of Nephron Sparing Shao, I-Hung Kan, Hung-Cheng Liu, Chung-Yi Lin, Po-Hung Yu, Kai-Jie Pang, See-Tong Wu, Chun-Te Chuang, Cheng-Keng Chang, Ying-Hsu Onco Targets Ther Original Research INTRODUCTION: Surgery remains the standard treatment for localized renal cell carcinomas, and partial nephrectomy is considered before radical nephrectomy with the aim of preserving renal function. This study aimed to compare robot-assisted and open partial nephrectomy for the purpose of nephron sparing. MATERIALS AND METHODS: We retrospectively enrolled consecutive patients who received partial nephrectomy at a single tertiary medical center from January 2008 to January 2015. Medical records and radiographic images were reviewed. We analyzed the patients’ general characteristics, underlying disease, complications, length of hospital stay, renal tumor complexity, surgery type, renal function, and specimen and tumor size. A comparison between open and robot-assisted nephrectomy groups was performed. RESULTS: A total of 136 patients were enrolled, with a male to female ratio of 2:3 and a mean age of 57.8 years. Of these, 71 and 65 patients received open and robot-assisted surgery, respectively. Compared with the open group, patients who underwent robot-assisted surgery were significantly younger (56.0 versus 60.1 years old), had a longer operative time (303 versus 224 min), and a lower kidney ischemic time (33.4 versus 46.9 min). Given similar tumor sizes, the tumor-to-excision ratio was significantly higher in the robot-assisted group (51.7% versus 39.8%), and the excisional volume loss (EVL) was smaller (12.7 versus 19.6 mL). Preoperative glomerular filtration rate and EVL were significant predictors of long-term renal function preservation in the multivariate analysis. CONCLUSION: When performing partial nephrectomy, a robot-assisted procedure could increase the accuracy of excision without increasing the risk of positive surgical margin. Lower EVL could assist in better long-term postoperative renal function preservation. Dove 2019-10-04 /pmc/articles/PMC6781943/ /pubmed/31632069 http://dx.doi.org/10.2147/OTT.S214060 Text en © 2019 Shao et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Shao, I-Hung
Kan, Hung-Cheng
Liu, Chung-Yi
Lin, Po-Hung
Yu, Kai-Jie
Pang, See-Tong
Wu, Chun-Te
Chuang, Cheng-Keng
Chang, Ying-Hsu
Role Of Robot-Assisted Partial Nephrectomy For Renal Cell Carcinomas In The Purpose Of Nephron Sparing
title Role Of Robot-Assisted Partial Nephrectomy For Renal Cell Carcinomas In The Purpose Of Nephron Sparing
title_full Role Of Robot-Assisted Partial Nephrectomy For Renal Cell Carcinomas In The Purpose Of Nephron Sparing
title_fullStr Role Of Robot-Assisted Partial Nephrectomy For Renal Cell Carcinomas In The Purpose Of Nephron Sparing
title_full_unstemmed Role Of Robot-Assisted Partial Nephrectomy For Renal Cell Carcinomas In The Purpose Of Nephron Sparing
title_short Role Of Robot-Assisted Partial Nephrectomy For Renal Cell Carcinomas In The Purpose Of Nephron Sparing
title_sort role of robot-assisted partial nephrectomy for renal cell carcinomas in the purpose of nephron sparing
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6781943/
https://www.ncbi.nlm.nih.gov/pubmed/31632069
http://dx.doi.org/10.2147/OTT.S214060
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