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EnglishPurpose: To evaluate the results of our technique of clampless laparoscopic partial nephrectomy (LPN) and its impact as an emerging treatment for small renal masses (SMRs). Materials and Methods: We reviewed our prospectively maintained database: data of 117 patients who consecutively underwent LPN at our Institution from January 2009 to December 2011 were studied. Patients were divided into 2 Groups based on operative technique: Group A: clampless-LPN (cl-LPN); Group B: conventional LPN (clamping of renal artery). Demographic and peri-operative data, complications, pre- and post-operative serum creatinine and estimated glomerular filtration rate (eGFR) were registered and compared by Student's t- and Chi-square-tests (p-values < 0.05 considered statistically significant). Results: 41 patients were in Group A and 76 in Group B. Groups were comparable in terms of preoperative data except for tumour's size (2.35 ± 1.10 vs. 3.19 ± 1.57, Group A vs. B, respectively, p = 0.0029). Concerning perioperative data, warm ischemia time (WIT) was 0 min. in all Group A cases; mean WIT in Group B was 20.90 ± 9.27 min. One case (2.4%) in Group A (central tumour) was converted to conventional LPN. Mean eGFR postoperative decrease was higher in Group B (0.17 ± 9.30 vs. 4.38 ± 11.37 mL/min., A vs B, respectively, p = 0.0445). Conclusions: Notwithstanding the limits ofthe study, our results suggest that cl-LPN is a safe and effective technique, which allows surgeon tosurgically treat SRMs even in case of complex location, without injuring kidney by ischemia.
| Titolo: | Clampless laparoscopic partial nephrectomy: a step towards a harmless nephron-sparing surgery? | |
| Autori Riconosciuti: | ||
| Autori: | Porpiglia, Francesco; Bertolo, R; Morra, I; Fiori, Cristian | |
| Data di pubblicazione: | 2012 | |
| Abstract: | Purpose: To evaluate the results of our technique of clampless laparoscopic partial nephrectomy (LPN) and its impact as an emerging treatment for small renal masses (SMRs). Materials and Methods: We reviewed our prospectively maintained database: data of 117 patients who consecutively underwent LPN at our Institution from January 2009 to December 2011 were studied. Patients were divided into 2 Groups based on operative technique: Group A: clampless-LPN (cl-LPN); Group B: conventional LPN (clamping of renal artery). Demographic and peri-operative data, complications, pre- and post-operative serum creatinine and estimated glomerular filtration rate (eGFR) were registered and compared by Student's t- and Chi-square-tests (p-values < 0.05 considered statistically significant). Results: 41 patients were in Group A and 76 in Group B. Groups were comparable in terms of preoperative data except for tumour's size (2.35 ± 1.10 vs. 3.19 ± 1.57, Group A vs. B, respectively, p = 0.0029). Concerning perioperative data, warm ischemia time (WIT) was 0 min. in all Group A cases; mean WIT in Group B was 20.90 ± 9.27 min. One case (2.4%) in Group A (central tumour) was converted to conventional LPN. Mean eGFR postoperative decrease was higher in Group B (0.17 ± 9.30 vs. 4.38 ± 11.37 mL/min., A vs B, respectively, p = 0.0445). Conclusions: Notwithstanding the limits ofthe study, our results suggest that cl-LPN is a safe and effective technique, which allows surgeon tosurgically treat SRMs even in case of complex location, without injuring kidney by ischemia. | |
| Volume: | 38 | |
| Fascicolo: | 4 | |
| Pagina iniziale: | 480 | |
| Pagina finale: | 488 | |
| Digital Object Identifier (DOI): | 10.1590/S1677-55382012000400007 | |
| Parole Chiave: | Ischemia; Laparoscopy; Nephrectomy | |
| Rivista: | INTERNATIONAL BRAZ J UROL | |
| Appare nelle tipologie: | 03A-Articolo su Rivista |
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