Selective Versus Hilar Clamping During Minimally Invasive Partial Nephrectomy: A Systematic Review and Meta-Analysis

Journal of Endourology
Liang ZhouKun-Jie Wang

Abstract

To compare the clinical efficacy and safety of selective vs hilar clamping during minimally invasive partial nephrectomy (PN). Studies comparing the effect and safety of selective versus hilar clamping during PN were identified by a systematic search using MEDLINE and EMBASE from January 2000 to November 2014. Quality of the selected studies was assessed according to the Newcastle-Ottawa Scale (NOS). A total of seven retrospective studies were included. No significant differences were observed between the two groups in age, body mass index, tumor size, pre-estimated glomerular filtration rate (eGFR), operative time, and length of stay. The selective clamping group had greater estimated blood loss (P<0.01) but similar blood transfusion rate (P=0.78) compared with the hilar clamping group. There were no significant differences between the two groups in terms of urinary leaks, overall complication rate, and positive margin rate. Patients who underwent selective clamping had a lower change in eGFR (mean difference [MD]: 13.95; 95% CI 8.85 to 19.05; P<0.01) and a lower percent change in eGFR (MD: 18.51; 95% CI 14.18 to 22.84; P<0.01) at 1 week. Combined results from two studies showed a trend toward a lower percent change in eGFR at...Continue Reading

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Citations

Nov 21, 2015·International Journal of Urology : Official Journal of the Japanese Urological Association·Ryoichi ShirokiHiroshi Toyama
Mar 30, 2016·Current Urology Reports·Zachary L Smith
Sep 2, 2017·Journal of Robotic Surgery·Barrett G AndersonR Sherburne Figenshau
Aug 28, 2018·Arab Journal of Urology·Chandran TanabalanFaiz Mumtaz
Jun 17, 2016·Current Opinion in Urology·Matthew J MauriceJihad H Kaouk

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