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‘Trifecta’ outcomes of robot-assisted partial nephrectomy: Results of the ‘low volume’ surgeon
OBJECTIVE: There is limited data regarding surgeon volume and partial nephrectomy outcomes. The aim of this study is to report trifecta outcomes of robot-assisted partial nephrectomy (RAPN) performed by the low volume surgeon. MATERIALS AND METHODS: Thirty-nine patients with clinical T1-2 renal tumo...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Sociedade Brasileira de Urologia
2020
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7527097/ https://www.ncbi.nlm.nih.gov/pubmed/32822123 http://dx.doi.org/10.1590/S1677-5538.IBJU.2019.0396 |
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author | Basatac, Cem Akpinar, Haluk |
author_facet | Basatac, Cem Akpinar, Haluk |
author_sort | Basatac, Cem |
collection | PubMed |
description | OBJECTIVE: There is limited data regarding surgeon volume and partial nephrectomy outcomes. The aim of this study is to report trifecta outcomes of robot-assisted partial nephrectomy (RAPN) performed by the low volume surgeon. MATERIALS AND METHODS: Thirty-nine patients with clinical T1-2 renal tumors who underwent RAPN between 2012 and 2018 were included in this study. Trifecta was defined as negative surgical margins, warm ischemia time ≤20 minutes, and no operative complications. Patient demographics, R.E.N.A.L. nephrometry score, operation time, estimated blood loss, warm ischemia time, length of hospital stay, renal functions, and oncological outcomes were analyzed retrospectively. Complications were graded based on the modified Clavien-Dindo classification system. RESULTS: The median R.E.N.A.L. nephrometry score was 6 (4-10). RAPN was successfully performed in all but one patient. The median operation time was 180 (90-240) minutes. Warm ischemia was performed only by segmental renal artery control in 35 and, by main renal artery control in three patients. The off-clamp technique was used in two patients. The median warm ischemia time was 16 (0-31) minutes. Seven patients had a warm ischemia time of longer than 20 minutes. Three patients had postoperative complications. The surgical margin was positive in one patient. As a result, the trifecta was achieved in 30 of the 39 patients (77%). CONCLUSION: RAPN is a safe and effective minimally invasive alternative in the treatment of renal masses. The present study suggests that reasonable trifecta rates can be achieved even by low volume surgeons. |
format | Online Article Text |
id | pubmed-7527097 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Sociedade Brasileira de Urologia |
record_format | MEDLINE/PubMed |
spelling | pubmed-75270972020-10-14 ‘Trifecta’ outcomes of robot-assisted partial nephrectomy: Results of the ‘low volume’ surgeon Basatac, Cem Akpinar, Haluk Int Braz J Urol Original Article OBJECTIVE: There is limited data regarding surgeon volume and partial nephrectomy outcomes. The aim of this study is to report trifecta outcomes of robot-assisted partial nephrectomy (RAPN) performed by the low volume surgeon. MATERIALS AND METHODS: Thirty-nine patients with clinical T1-2 renal tumors who underwent RAPN between 2012 and 2018 were included in this study. Trifecta was defined as negative surgical margins, warm ischemia time ≤20 minutes, and no operative complications. Patient demographics, R.E.N.A.L. nephrometry score, operation time, estimated blood loss, warm ischemia time, length of hospital stay, renal functions, and oncological outcomes were analyzed retrospectively. Complications were graded based on the modified Clavien-Dindo classification system. RESULTS: The median R.E.N.A.L. nephrometry score was 6 (4-10). RAPN was successfully performed in all but one patient. The median operation time was 180 (90-240) minutes. Warm ischemia was performed only by segmental renal artery control in 35 and, by main renal artery control in three patients. The off-clamp technique was used in two patients. The median warm ischemia time was 16 (0-31) minutes. Seven patients had a warm ischemia time of longer than 20 minutes. Three patients had postoperative complications. The surgical margin was positive in one patient. As a result, the trifecta was achieved in 30 of the 39 patients (77%). CONCLUSION: RAPN is a safe and effective minimally invasive alternative in the treatment of renal masses. The present study suggests that reasonable trifecta rates can be achieved even by low volume surgeons. Sociedade Brasileira de Urologia 2020-09-02 /pmc/articles/PMC7527097/ /pubmed/32822123 http://dx.doi.org/10.1590/S1677-5538.IBJU.2019.0396 Text en https://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Basatac, Cem Akpinar, Haluk ‘Trifecta’ outcomes of robot-assisted partial nephrectomy: Results of the ‘low volume’ surgeon |
title | ‘Trifecta’ outcomes of robot-assisted partial nephrectomy: Results of the ‘low volume’ surgeon |
title_full | ‘Trifecta’ outcomes of robot-assisted partial nephrectomy: Results of the ‘low volume’ surgeon |
title_fullStr | ‘Trifecta’ outcomes of robot-assisted partial nephrectomy: Results of the ‘low volume’ surgeon |
title_full_unstemmed | ‘Trifecta’ outcomes of robot-assisted partial nephrectomy: Results of the ‘low volume’ surgeon |
title_short | ‘Trifecta’ outcomes of robot-assisted partial nephrectomy: Results of the ‘low volume’ surgeon |
title_sort | ‘trifecta’ outcomes of robot-assisted partial nephrectomy: results of the ‘low volume’ surgeon |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7527097/ https://www.ncbi.nlm.nih.gov/pubmed/32822123 http://dx.doi.org/10.1590/S1677-5538.IBJU.2019.0396 |
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