OBJECTIVES: To assess trifecta outcomes for laparoscopic partial nephrectomy for clinical T1a renal masses. METHODS: A total of 63 patients who underwent laparoscopic partial nephrectomy for clinical T1a renal masses by a single surgeon between January 2007 and December 2012 were evaluated. Demographic and perioperative data were collected and statistically analyzed. We retrospectively evaluated trifecta outcomes. Multivariable logistic regression models were used to analyze predictors of trifecta outcomes. Trifecta outcomes were defined as the combination of total ischemia time <25 min, negative surgical margins and no surgical complications. RESULTS: Of the 63 patients, 39 (62%) achieved trifecta. A total of 21 patients had total ischemia time ≥25 min, four patients had positive surgical margins and two patients had surgical complications. Tumor size (P < 0.001), distance from the urine collecting system or sinus (P < 0.001) and surgeon's learning curve (P < 0.01) were significantly different between the trifecta and no-trifecta group. Multivariate analysis showed tumor size and surgeon's learning curve to be independent predictors of trifecta outcomes. CONCLUSIONS: Tumor size and surgeon's learning curve seems to be strong predictors of trifecta outcomes after laparoscopic partial nephrectomy in T1a renal masses.
OBJECTIVES: To assess trifecta outcomes for laparoscopic partial nephrectomy for clinical T1a renal masses. METHODS: A total of 63 patients who underwent laparoscopic partial nephrectomy for clinical T1a renal masses by a single surgeon between January 2007 and December 2012 were evaluated. Demographic and perioperative data were collected and statistically analyzed. We retrospectively evaluated trifecta outcomes. Multivariable logistic regression models were used to analyze predictors of trifecta outcomes. Trifecta outcomes were defined as the combination of total ischemia time <25 min, negative surgical margins and no surgical complications. RESULTS: Of the 63 patients, 39 (62%) achieved trifecta. A total of 21 patients had total ischemia time ≥25 min, four patients had positive surgical margins and two patients had surgical complications. Tumor size (P < 0.001), distance from the urine collecting system or sinus (P < 0.001) and surgeon's learning curve (P < 0.01) were significantly different between the trifecta and no-trifecta group. Multivariate analysis showed tumor size and surgeon's learning curve to be independent predictors of trifecta outcomes. CONCLUSIONS:Tumor size and surgeon's learning curve seems to be strong predictors of trifecta outcomes after laparoscopic partial nephrectomy in T1a renal masses.
Authors: Andrea Piasentin; Francesco Claps; Tommaso Silvestri; Giacomo Rebez; Fabio Traunero; Maria Carmen Mir; Michele Rizzo; Antonio Celia; Calogero Cicero; Martina Urbani; Luca Balestreri; Lisa Pola; Fulvio Laganà; Stefano Cernic; Maria Assunta Cova; Michele Bertolotto; Carlo Trombetta; Giovanni Liguori; Nicola Pavan Journal: Medicina (Kaunas) Date: 2022-08-03 Impact factor: 2.948