OBJECTIVE: To explore the margin, ischemia, and complications (MIC) system achievement rate within a population of patients who were treated with robotic partial nephrectomy (RAPN), at 3 different tertiary care centers, and to determine the factors predicting MIC achievement. METHODS: The study population consisted of 339 patients who underwent RAPN for cT1 renal tumors at 3 centers. Cancer control was defined as the absence of positive surgical margin. Ideal threshold of warm ischemia time (WIT) was considered ≤20 minutes. Safety was defined as the absence of major complications. The achievement of MIC was considered as the fulfillment of all these 3 outcomes. The primary endpoint was to determine the MIC rate in our study population; the secondary endpoint was to detect factors affecting its achievement. RESULTS: The overall MIC rate was 67%. Median WIT was 17 minutes (range, 7-51 minutes). In 88 cases (26%), WIT was >20 minutes. Positive surgical margins were found in 22 patients (6.5%). Overall postoperative and major complication rates were 14.5% (n = 49) and 3.8% (n = 13). In multivariate logistic regression analysis, continuously coded and categorically coded preoperative aspects and dimensions used for an anatomical scores were an independent predictor of MIC achievement (odds ratio, 0.636; confidence interval, 0.436-0.928; P = .019 and odds ratio, 0.098; confidence interval, 0.030-0.326; P <.001). CONCLUSION: The MIC binary system may represent a useful tool to summarize the achievement of optimal perioperative outcomes of RAPN. In the current population, tumor complexity was significantly associated with MIC achievement.
OBJECTIVE: To explore the margin, ischemia, and complications (MIC) system achievement rate within a population of patients who were treated with robotic partial nephrectomy (RAPN), at 3 different tertiary care centers, and to determine the factors predicting MIC achievement. METHODS: The study population consisted of 339 patients who underwent RAPN for cT1renal tumors at 3 centers. Cancer control was defined as the absence of positive surgical margin. Ideal threshold of warm ischemia time (WIT) was considered ≤20 minutes. Safety was defined as the absence of major complications. The achievement of MIC was considered as the fulfillment of all these 3 outcomes. The primary endpoint was to determine the MIC rate in our study population; the secondary endpoint was to detect factors affecting its achievement. RESULTS: The overall MIC rate was 67%. Median WIT was 17 minutes (range, 7-51 minutes). In 88 cases (26%), WIT was >20 minutes. Positive surgical margins were found in 22 patients (6.5%). Overall postoperative and major complication rates were 14.5% (n = 49) and 3.8% (n = 13). In multivariate logistic regression analysis, continuously coded and categorically coded preoperative aspects and dimensions used for an anatomical scores were an independent predictor of MIC achievement (odds ratio, 0.636; confidence interval, 0.436-0.928; P = .019 and odds ratio, 0.098; confidence interval, 0.030-0.326; P <.001). CONCLUSION: The MIC binary system may represent a useful tool to summarize the achievement of optimal perioperative outcomes of RAPN. In the current population, tumor complexity was significantly associated with MIC achievement.
Authors: Francesco Greco; Riccardo Autorino; Vincenzo Altieri; Steven Campbell; Vincenzo Ficarra; Inderbir Gill; Alexander Kutikov; Alex Mottrie; Vincenzo Mirone; Hendrik van Poppel Journal: Eur Urol Date: 2018-10-13 Impact factor: 24.267
Authors: Dae Keun Kim; Lawrence H C Kim; Ali Abdel Raheem; Tae Young Shin; Ibrahim Alabdulaali; Young Eun Yoon; Woong Kyu Han; Koon Ho Rha Journal: PLoS One Date: 2016-03-17 Impact factor: 3.240
Authors: Raouf M Seyam; Mohammed M Alalawi; Waleed K Alkhudair; Hassan M Alzahrani; Raed A Azhar; Khalid I Alothman; Turki O Al-Hussain; Mohammed F Alotaibi Journal: Saudi Med J Date: 2019-01 Impact factor: 1.484