Fabrizio Gallo1, Simone Sforza2, Lorenzo Luciani3, Daniele Mattevi3, Paolo Barzaghi2, Andrea Mari2, Fabrizio Di Maida2, Alessandro Antonelli4, Luca Cindolo5, Antonio Galfano6, Giovannalberto Pini7, Guglielmo Mantica8, Maurizio Schenone9, Luigi Schips10, Filippo Annino11, Carlo Terrone8, Aldo Massimo Bocciardi6, Franco Gaboardi7, Andrea Minervini2. 1. Department of Urology, San Paolo Hospital, Savona, Italy. fabriziogallo.sv@gmail.com. 2. Department of Urology, Careggi University Hospital, Florence, Italy. 3. Department of Urology, Santa Chiara Hospital, Trento, Italy. 4. Department of Urology, University of Brescia, Brescia, Italy. 5. Department of Urology, Villa Stuart Private Hospital, Rome, Italy. 6. Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy. 7. Department of Urology, Ospedale San Raffaele-Turro, Milan, Italy. 8. Department of Urology, Policlinico San Martino Hospital, University of Genoa, Genoa, Italy. 9. Department of Urology, San Paolo Hospital, Savona, Italy. 10. Department of Medical, Oral and Biotechnological Sciences, "SS. Annunziata" Hospital, Urology Unit, University of Chieti, Chieti, Italy. 11. Department of Urology, San Donato Hospital, Arezzo, Italy.
Abstract
PURPOSE: There is currently no consensus regarding the optimal treatment strategy for patients presenting with synchronous bilateral renal masses. The decision to perform bilateral procedures on the same intervention or in staged procedures is debated. The aim of this manuscript is to analyse the outcomes of simultaneous robot-assisted partial nephrectomy (RAPN) in a series of patients with bilateral renal masses treated at five Italian robotic institutions. METHODS: Data from a prospectively maintained multi-institutional database on patients subjected to simultaneous RAPN between November 2011 and July 2019 were reviewed. RAPNs were performed with da Vinci Si or Xi surgical system by expert robotic surgeons. Baseline demographics and clinical features, peri- and post-operative data were collected. RESULTS: Overall, 27 patients underwent simultaneous bilateral RAPN, and 54 RAPNs were performed without need of conversion; median operative time was 250 minutes, median estimated blood loss was 200 mL. Renal artery clamping was needed for 27 (50%) RAPNs with a median warm ischemia time of 15 minutes and no case of acute kidney injury. Complications were reported in 7 (25.9%) patients, mainly represented by Clavien 2 events (6 blood transfusions). Positive surgical margins were assessed in 2 (3.7%) of the renal cell carcinoma. At the median follow-up of 30 months, recurrence-free survival was 100%. CONCLUSION: Our data showed that, in selected patients and expert hands, simultaneous bilateral RAPNs could be a safe and feasible procedure with promising results for the treatment of bilateral synchronous renal masses.
PURPOSE: There is currently no consensus regarding the optimal treatment strategy for patients presenting with synchronous bilateral renal masses. The decision to perform bilateral procedures on the same intervention or in staged procedures is debated. The aim of this manuscript is to analyse the outcomes of simultaneous robot-assisted partial nephrectomy (RAPN) in a series of patients with bilateral renal masses treated at five Italian robotic institutions. METHODS: Data from a prospectively maintained multi-institutional database on patients subjected to simultaneous RAPN between November 2011 and July 2019 were reviewed. RAPNs were performed with da Vinci Si or Xi surgical system by expert robotic surgeons. Baseline demographics and clinical features, peri- and post-operative data were collected. RESULTS: Overall, 27 patients underwent simultaneous bilateral RAPN, and 54 RAPNs were performed without need of conversion; median operative time was 250 minutes, median estimated blood loss was 200 mL. Renal artery clamping was needed for 27 (50%) RAPNs with a median warm ischemia time of 15 minutes and no case of acute kidney injury. Complications were reported in 7 (25.9%) patients, mainly represented by Clavien 2 events (6 blood transfusions). Positive surgical margins were assessed in 2 (3.7%) of the renal cell carcinoma. At the median follow-up of 30 months, recurrence-free survival was 100%. CONCLUSION: Our data showed that, in selected patients and expert hands, simultaneous bilateral RAPNs could be a safe and feasible procedure with promising results for the treatment of bilateral synchronous renal masses.
Authors: Andrea Mari; Riccardo Tellini; Fabrizio Di Maida; Riccardo Campi; Paolo Barzaghi; Giovanni Tasso; Simone Sforza; Agostino Tuccio; Giampaolo Siena; Lorenzo Masieri; Marco Carini; Andrea Minervini Journal: Minerva Urol Nefrol Date: 2019-12-12 Impact factor: 3.720
Authors: Frank Kunath; Stefanie Schmidt; Laura-Maria Krabbe; Arkadiusz Miernik; Philipp Dahm; Anne Cleves; Mario Walther; Nils Kroeger Journal: Cochrane Database Syst Rev Date: 2017-05-09
Authors: Tobias Klatte; Heiko Wunderlich; Jean-Jacques Patard; Mark D Kleid; John S Lam; Kerstin Junker; Jörg Schubert; Malte Böhm; Ernst P Allhoff; Fairooz F Kabbinavar; Maxime Crepel; Luca Cindolo; Alexandre De La Taille; Jacques Tostain; Arnaud Mejean; Michel Soulie; Laurent Bellec; Jean Christophe Bernhard; Jean-Marie Ferriere; Christian Pfister; Baptiste Albouy; Marc Colombel; Amnon Zisman; Arie S Belldegrun; Allan J Pantuck Journal: BJU Int Date: 2007-04-13 Impact factor: 5.588
Authors: Ross J Mason; Thomas Atwell; Christine Lohse; Bimal Bhindi; Grant Schmit; John Schmitz; Bradley C Leibovich; Stephen A Boorjian; R Houston Thompson Journal: BJU Int Date: 2018-04-29 Impact factor: 5.588
Authors: Silvia Proietti; Jean de la Rosette; Brian Eisner; Franco Gaboardi; Cristian Fiori; Ella Kinzikeeva; Lorenzo Luciani; Roberto Miano; Francesco Porpiglia; Marco Rosso; Mario Sofer; Olivier Traxer; Guido Giusti Journal: Minerva Urol Nefrol Date: 2017-10 Impact factor: 3.720