Amir H Lebastchi1, Brittnee Haynes1, Sandeep Gurram1, Gennady Bratslavsky2, Adam R Metwalli3, W Marston Linehan1, Mark W Ball4. 1. Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD. 2. Department of Urology, SUNY Upstate Medical University, Syracuse, NY. 3. Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD; Division of Urology, Department of Surgery, Howard University Hospital, Washington, DC. 4. Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD. Electronic address: Mark.Ball@nih.gov.
Abstract
OBJECTIVE: To describe the X-Capsular Incision for Tumor Enucleation (X-CITE) technique to resect endophytic renal tumors while preserving the overlying renal parenchyma. SUBJECTS AND METHODS: We reviewed 1-year outcomes of 12 consecutive patients with a history of bilateral or multifocal renal tumors who presented to our institution with completely endophytic renal masse(s) between August 2017 and August 2018. Endophytic tumors were resected by making an X-shaped incision in the renal capsule and developing parenchymal flaps overlying the tumor pseudocapsule. Following tumor enucleation, the overlying parenchymal flaps were reapproximated. RESULTS: Median follow up was 19.9 months (range 10.6-14.9). Most patients also had additional exophytic tumors with a median of 5 renal tumors removed per operation with a median largest renal tumor size of 3.2 cm. No intraoperative or postoperative complications occurred. There was no decline in renal function after surgery when comparing median pre- and 12-month postoperative eGFR (94.5 vs 91.5, P= 0.18).). Postoperative nuclear mercaptoacetyltriglycine (MAG-3) renal scans demonstrated equal differential kidney function after surgery. Limitations include short-term follow-up and referral bias at center specializing in multi-focal kidney surgery. CONCLUSION: The X-Capsular Incision for Tumor Enucleation technique is feasible, safe and effective with minimal collateral damage in the treatment of completely endophytic renal masses. Further investigation should identify which patients may benefit from this procedure and explore intermediate and long-term outcomes. Published by Elsevier Inc.
OBJECTIVE: To describe the X-Capsular Incision for Tumor Enucleation (X-CITE) technique to resect endophytic renal tumors while preserving the overlying renal parenchyma. SUBJECTS AND METHODS: We reviewed 1-year outcomes of 12 consecutive patients with a history of bilateral or multifocal renal tumors who presented to our institution with completely endophytic renal masse(s) between August 2017 and August 2018. Endophytic tumors were resected by making an X-shaped incision in the renal capsule and developing parenchymal flaps overlying the tumor pseudocapsule. Following tumor enucleation, the overlying parenchymal flaps were reapproximated. RESULTS: Median follow up was 19.9 months (range 10.6-14.9). Most patients also had additional exophytic tumors with a median of 5 renal tumors removed per operation with a median largest renal tumor size of 3.2 cm. No intraoperative or postoperative complications occurred. There was no decline in renal function after surgery when comparing median pre- and 12-month postoperative eGFR (94.5 vs 91.5, P= 0.18).). Postoperative nuclear mercaptoacetyltriglycine (MAG-3) renal scans demonstrated equal differential kidney function after surgery. Limitations include short-term follow-up and referral bias at center specializing in multi-focal kidney surgery. CONCLUSION: The X-Capsular Incision for Tumor Enucleation technique is feasible, safe and effective with minimal collateral damage in the treatment of completely endophytic renal masses. Further investigation should identify which patients may benefit from this procedure and explore intermediate and long-term outcomes. Published by Elsevier Inc.
Authors: Kevin M Curtiss; Mark W Ball; Michael A Gorin; Kelly T Harris; Phillip M Pierorazio; Mohamad E Allaf Journal: J Endourol Date: 2014-07-31 Impact factor: 2.942
Authors: N Longo; A Minervini; A Antonelli; G Bianchi; A M Bocciardi; S C Cunico; C Fiori; F Fusco; S Giancane; A Mari; G Martorana; V Mirone; G Morgia; G Novara; F Porpiglia; M R Raspollini; F Rocco; B Rovereto; R Schiavina; S Serni; C Simeone; P Verze; A Volpe; V Ficarra; M Carini Journal: Eur J Surg Oncol Date: 2014-02-01 Impact factor: 4.424
Authors: Robert H Blackwell; Belinda Li; Zachary Kozel; Zhiling Zhang; Juping Zhao; Wen Dong; Sarah E Capodice; Gregory Barton; Arpeet Shah; Jessica J Wetterlin; Marcus L Quek; Steven C Campbell; Gopal N Gupta Journal: Urology Date: 2016-09-07 Impact factor: 2.649
Authors: Lu Wang; Ian Hughes; Connor Snarskis; Helyn Alvarez; Jingyang Feng; Gopal N Gupta; Maria M Picken Journal: Virchows Arch Date: 2016-10-24 Impact factor: 4.064