Trifecta and Pentafecta Rates After Robotic Assisted Partial Nephrectomy: Comparative Study of Patients with Renal Masses <4 and ≥4 cm

Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a
Roberto CastellucciLuigi Schips

Abstract

Robotic-assisted partial nephrectomy (RAPN) is preferred to radical nephrectomy because it guarantees superior functional outcomes in patients with small renal masses (RMs). Only a few studies so far have evaluated the feasibility of RAPN for the treatment of RM ≥4 cm. The aim of this study is to evaluate the safety and feasibility of RAPN based on a comparison of trifecta and pentafecta rates for RMs ≥4 cm. We retrospectively analyzed prospectively collected data from an institutional database of patients undergoing RAPN from September 2013 to November 2016. Demographic and perioperative data were collected and statistically analyzed. Pentafecta is defined as achievement of trifecta (negative surgical margins, no postoperative complications, and warm ischemia time ≤25 minutes) with the addition of two other variables, namely, over 90% estimated glomerular filtration rate preservation and no chronic kidney disease stage progression 1 year after surgery. Overall, 123 patients underwent RAPN. Of those, 38 (30.9%) had RMs ≥4 cm. Trifecta was achieved in 72.9% of patients with RMs <4 cm and in 44.7% of those with ≥4 cm, whereas pentafecta was achieved by 23.5% of patients with RMs <4 cm and by 10.5% of those with RMs ≥4 cm. No sign...Continue Reading

References

Jul 16, 2003·Annals of Internal Medicine·Andrew S LeveyUNKNOWN National Kidney Foundation
Nov 13, 2007·The Journal of Urology·Sascha PahernikJoachim W Thüroff
Dec 1, 2009·European Urology·Manish N PatelCraig G Rogers
Feb 26, 2011·International Journal of Cancer. Journal International Du Cancer·Jacques FerlayDonald Maxwell Parkin
Nov 21, 2012·The Journal of Urology·Andrew J HungInderbir S Gill
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Jan 27, 2015·European Urology·Borje LjungbergAxel Bex
Aug 8, 2015·International Journal of Urology : Official Journal of the Japanese Urological Association·Kimito OsakaMasahiro Yao

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Citations

Jan 5, 2019·Minerva urologica e nefrologica = The Italian journal of urology and nephrology·Luca CindoloUNKNOWN AGILE Group (Italian Group For Advanced Laparo-Endoscopic Surgery)
Oct 18, 2019·Minerva urologica e nefrologica = The Italian journal of urology and nephrology·Lorenzo BianchiEugenio Brunocilla
Apr 18, 2019·Journal of Robotic Surgery·Amanda E KahnDavid D Thiel

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