Cargando…

‘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...

Descripción completa

Detalles Bibliográficos
Autores principales: Basatac, Cem, Akpinar, Haluk
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sociedade Brasileira de Urologia 2020
Materias:
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
_version_ 1783588981740404736
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
work_keys_str_mv AT basataccem trifectaoutcomesofrobotassistedpartialnephrectomyresultsofthelowvolumesurgeon
AT akpinarhaluk trifectaoutcomesofrobotassistedpartialnephrectomyresultsofthelowvolumesurgeon