Sheng-Han Tsai1,2,3, Yi-Chen Lai4,5, Nai-Yuan Wu6, Hsiao-Jen Chung7,8. 1. Department of Urology, Cheng-Hsin General Hospital, Taipei, Taiwan, ROC. 2. Department of Urology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei, 11217, Taiwan, ROC. 3. Department of Urology, School of Medicine and Shu-Tien Urological Research Institute, National Yang-Ming University, Taipei, Taiwan, ROC. 4. Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC. 5. Department of Radiology, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC. 6. Institute of Biomedical Informatics, National Yang-Ming University, Taipei, Taiwan, ROC. 7. Department of Urology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei, 11217, Taiwan, ROC. hjchung@vghtpe.gov.tw. 8. Department of Urology, School of Medicine and Shu-Tien Urological Research Institute, National Yang-Ming University, Taipei, Taiwan, ROC. hjchung@vghtpe.gov.tw.
Abstract
PURPOSE: Relative few studies reported the changes in split renal function using renal scintigraphy for robot-assisted partial nephrectomy (RaPN) for renal tumor >4 cm. This study aimed at demonstrating that RaPN is safe for renal tumor >4 cm without damaging the renal function of ipsilateral and contralateral kidney. METHODS: Patients who underwent RaPN for single renal tumor from December 2009 to December 2013 were identified from a prospectively collected database. We compared demographic, perioperative, and postoperative outcomes between patients with renal tumor >4 cm (case group) and patients with renal tumor ≦4 cm (control group). Renal function was assessed by serum creatinine, estimated glomerular filtration rate, and effective renal plasma flow (ERPF). RESULTS: One hundred and three consecutive patients (45 in case group and 58 in control group) were identified. Case group had significantly longer operative time (P = 0.011), longer warm ischemia time (P < 0.001), and more estimated blood loss (P = 0.010) than control group. Only one patient in the case group had conversion surgery. There was no significant difference regarding hospital stay, blood transfusion, complications rate, and positive surgical margin. The changes in ipsilateral ERPF and contralateral ERPF were not significantly different between groups (ipsilateral kidney: -10.5 vs. -12.5%, P = 0.989; contralateral kidney: -3.6 vs. -5.2%, P = 0.611). CONCLUSIONS: RaPN is a safe and feasible modality of nephron-sparing surgery for renal tumor >4 cm, as it is for renal tumor ≦4 cm.
PURPOSE: Relative few studies reported the changes in split renal function using renal scintigraphy for robot-assisted partial nephrectomy (RaPN) for renal tumor >4 cm. This study aimed at demonstrating that RaPN is safe for renal tumor >4 cm without damaging the renal function of ipsilateral and contralateral kidney. METHODS:Patients who underwent RaPN for single renal tumor from December 2009 to December 2013 were identified from a prospectively collected database. We compared demographic, perioperative, and postoperative outcomes between patients with renal tumor >4 cm (case group) and patients with renal tumor ≦4 cm (control group). Renal function was assessed by serum creatinine, estimated glomerular filtration rate, and effective renal plasma flow (ERPF). RESULTS: One hundred and three consecutive patients (45 in case group and 58 in control group) were identified. Case group had significantly longer operative time (P = 0.011), longer warm ischemia time (P < 0.001), and more estimated blood loss (P = 0.010) than control group. Only one patient in the case group had conversion surgery. There was no significant difference regarding hospital stay, blood transfusion, complications rate, and positive surgical margin. The changes in ipsilateral ERPF and contralateral ERPF were not significantly different between groups (ipsilateral kidney: -10.5 vs. -12.5%, P = 0.989; contralateral kidney: -3.6 vs. -5.2%, P = 0.611). CONCLUSIONS: RaPN is a safe and feasible modality of nephron-sparing surgery for renal tumor >4 cm, as it is for renal tumor ≦4 cm.
Authors: Matthew T Gettman; Michael L Blute; George K Chow; Richard Neururer; Georg Bartsch; Reinhard Peschel Journal: Urology Date: 2004-11 Impact factor: 2.649
Authors: Borje Ljungberg; Karim Bensalah; Steven Canfield; Saeed Dabestani; Fabian Hofmann; Milan Hora; Markus A Kuczyk; Thomas Lam; Lorenzo Marconi; Axel S Merseburger; Peter Mulders; Thomas Powles; Michael Staehler; Alessandro Volpe; Axel Bex Journal: Eur Urol Date: 2015-01-21 Impact factor: 20.096
Authors: Inderbir S Gill; Louis R Kavoussi; Brian R Lane; Michael L Blute; Denise Babineau; J Roberto Colombo; Igor Frank; Sompol Permpongkosol; Christopher J Weight; Jihad H Kaouk; Michael W Kattan; Andrew C Novick Journal: J Urol Date: 2007-05-11 Impact factor: 7.450
Authors: Andrew S Levey; Lesley A Stevens; Christopher H Schmid; Yaping Lucy Zhang; Alejandro F Castro; Harold I Feldman; John W Kusek; Paul Eggers; Frederick Van Lente; Tom Greene; Josef Coresh Journal: Ann Intern Med Date: 2009-05-05 Impact factor: 25.391
Authors: Yash S Khandwala; In Gab Jeong; Deok Hyun Han; Jae Heon Kim; Shufeng Li; Ye Wang; Steven L Chang; Benjamin I Chung Journal: Int Urol Nephrol Date: 2017-08-29 Impact factor: 2.370
Authors: Giovanni Di Lascio; Alessandro Sciarra; Francesco Del Giudice; Stefano Salciccia; Gian Maria Busetto; Ettore De Berardinis; Gian Piero Ricciuti; Daniele Castellani; Giacomo Maria Pirola; Martina Maggi; Alessandro Gentilucci; Susanna Cattarino; Gianna Mariotti; Paolo Casale; Giovanni Battista Di Pierro Journal: Cent European J Urol Date: 2022-01-12