Tailoring technique of laparoscopic partial nephrectomy to tumor characteristics

The Journal of Urology
Alon Z WeizerJ Stuart Wolf

Abstract

We use a tailored approach to laparoscopic partial nephrectomy based on tumor depth of penetration and proximity to the renal sinus. We evaluated differences in perioperative outcomes to determine the value of this paradigm. The surgical approach to hilar clamping and tumor bed management during laparoscopic partial nephrectomy included no clamp or suture, clamp with no suture, and clamp and suture. The end points assessed retrospectively were differences in perioperative, pathological and complication outcomes among these groups. Our surgical paradigm was used in 174 patients, including no clamp or suture in 36, clamp with no suture in 25, and clamp and suture in 113. Compared to the other patients those with a clamp and suture procedure were older with larger and deeper tumors that were closer to the renal sinus-collecting system and more likely to be malignant. Operative time was shortest in the no clamp or suture group and in the 2 clamp groups warm ischemia and operative times were shorter than in the no suture group. Estimated blood loss, hospital stay, surgical margins, complications and recurrences did not differ among the groups. A creatinine increase of 0.3 mg/dl or greater was seen in 33 patients (19%) following surg...Continue Reading

References

May 29, 2003·The Journal of Urology·Scott D SimonPaul E Andrews
Jun 11, 2003·The Journal of Urology·Inderbir S GillJihad H Kaouk
Jun 11, 2003·The Journal of Urology·Inderbir S GillAndrew C Novick
Dec 11, 2003·The Journal of Urology·Günter JanetschekManfred Gschwendtner
Dec 22, 2004·Current Urology Reports·William K Johnston, J Stuart Wolf
Jan 22, 2005·Journal of Endourology·Brian D SeifmanJ Stuart Wolf
May 25, 2005·Journal of Endourology·S Duke Herrell, Brian M Levin
Jun 11, 2005·The Journal of Urology·William K JohnstonJ Stuart Wolf
Sep 8, 2005·The Journal of Urology·Sompol PermpongkosolLouis R Kavoussi
Jun 19, 2007·The Journal of Urology·Inderbir S GillAndrew C Novick

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Citations

May 7, 2010·Surgical Endoscopy·Ofer N GofritYoav Mintz
Apr 28, 2012·Current Urology Reports·Serge GinzburgAlexander Kutikov
May 29, 2009·Journal of Endourology·Rabii Madi, J Stuart Wolf
Jul 16, 2010·Journal of Endourology·Hyun Jung KooIsaac Yi Kim
Mar 9, 2011·Journal of Endourology·Alon Z WeizerKhaled S Hafez
Mar 19, 2011·Journal of Endourology·Sam B Bhayani
Mar 22, 2013·Journal of Endourology·Juan Antonio PeñaHumberto Villavicencio
Apr 17, 2012·Urology·Ryan NovakRonney Abaza
Jul 2, 2011·Urologic Oncology·Jeffery C WheatAlon Z Weizer
Aug 30, 2012·Urologic Oncology·J Stuart Wolf
Oct 14, 2011·BJU International·Soroush Rais-BahramiLouis R Kavoussi
Nov 7, 2012·International Journal of Urology : Official Journal of the Japanese Urological Association·Jonathan S EllisonAlon Z Weizer
Jan 23, 2019·International Journal of Urology : Official Journal of the Japanese Urological Association·Zhong-Yuan ZhangLi-Qun Zhou

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