Abstract
OBJECTIVE: • To describe the technique and report the results of 'zero ischaemia', sutureless laparoscopic partial nephrectomy (LPN) for renal tumours with a low nephrometry score. PATIENTS AND METHODS: • Between August 2003 and January 2010, data from 101 consecutive patients who underwent 'zero ischaemia', sutureless LPN were collected in a prospectively maintained database. • Inclusion criteria were tumour size ≤ 4 cm, predominant exophytic growth and intraparenchymal depth ≤ 1.5 cm, with a minimum distance of 5 mm from the urinary collecting system. • Hilar vessels were not isolated, tumour dissection was performed with 10-mm LigaSure TM (Covidien, Boulder, CO, USA) and haemostasis was performed with coagulation and biological haemostatic agents without reconstructing the renal parenchyma. • Clinical, perioperative and follow-up data were collected prospectively, and modifications of functional outcome variables were analysed using the paired Wilcoxon test. RESULTS: • The median (range) tumour size was 2.4 (1.5-4) cm, and the median (range) intraparenchymal depth was 0.7 (0.4-1.4) cm. • Hilar clamping was not necessary in any patient, and suture was performed in four patients to ensure complete haemostasis. The median (range) operation duration was 60 (45-160) min, and median (range) intraoperative blood loss was 100 (20-240) mL. • Postoperative complications included fever (n = 4), low urinary output (n = 3) and haematoma, which was treated conservatively (n = 2). The median (range) hospital stay was 3 (2-5) days. The pathologist reported 30 benign tumours and renal cell carcinoma in 71 cases (pT1a in 69 patients, and pT1b in two patients). • At a median follow-up of 57 months, one patient underwent radical nephrectomy for ipsilateral recurrence. The 1-year median (range) decrease of split renal function at renal scintigraphy was 1 (0-5) %. CONCLUSIONS: • Zero ischaemia LPN is a reasonable approach to treating small and peripheral tumours, and a sutureless procedure is feasible in most cases. • This technique has a low complication rate and provides excellent functional outcome without impairing oncological results.
| Original language | English |
|---|---|
| Pages (from-to) | 124-130 |
| Number of pages | 7 |
| Journal | BJU International |
| Volume | 110 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Jul 2012 |
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Keywords
- Ischaemia
- Kidney neoplasms
- Kidney tumour
- Laparoscopy
- Partial nephrectomy
- Unclamped
ASJC Scopus subject areas
- Urology
Cite this
'Zero ischaemia', sutureless laparoscopic partial nephrectomy for renal tumours with a low nephrometry score. / Simone, Giuseppe; Papalia, Rocco; Guaglianone, Salvatore; Gallucci, Michele.
In: BJU International, Vol. 110, No. 1, 07.2012, p. 124-130.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - 'Zero ischaemia', sutureless laparoscopic partial nephrectomy for renal tumours with a low nephrometry score
AU - Simone, Giuseppe
AU - Papalia, Rocco
AU - Guaglianone, Salvatore
AU - Gallucci, Michele
PY - 2012/7
Y1 - 2012/7
N2 - OBJECTIVE: • To describe the technique and report the results of 'zero ischaemia', sutureless laparoscopic partial nephrectomy (LPN) for renal tumours with a low nephrometry score. PATIENTS AND METHODS: • Between August 2003 and January 2010, data from 101 consecutive patients who underwent 'zero ischaemia', sutureless LPN were collected in a prospectively maintained database. • Inclusion criteria were tumour size ≤ 4 cm, predominant exophytic growth and intraparenchymal depth ≤ 1.5 cm, with a minimum distance of 5 mm from the urinary collecting system. • Hilar vessels were not isolated, tumour dissection was performed with 10-mm LigaSure TM (Covidien, Boulder, CO, USA) and haemostasis was performed with coagulation and biological haemostatic agents without reconstructing the renal parenchyma. • Clinical, perioperative and follow-up data were collected prospectively, and modifications of functional outcome variables were analysed using the paired Wilcoxon test. RESULTS: • The median (range) tumour size was 2.4 (1.5-4) cm, and the median (range) intraparenchymal depth was 0.7 (0.4-1.4) cm. • Hilar clamping was not necessary in any patient, and suture was performed in four patients to ensure complete haemostasis. The median (range) operation duration was 60 (45-160) min, and median (range) intraoperative blood loss was 100 (20-240) mL. • Postoperative complications included fever (n = 4), low urinary output (n = 3) and haematoma, which was treated conservatively (n = 2). The median (range) hospital stay was 3 (2-5) days. The pathologist reported 30 benign tumours and renal cell carcinoma in 71 cases (pT1a in 69 patients, and pT1b in two patients). • At a median follow-up of 57 months, one patient underwent radical nephrectomy for ipsilateral recurrence. The 1-year median (range) decrease of split renal function at renal scintigraphy was 1 (0-5) %. CONCLUSIONS: • Zero ischaemia LPN is a reasonable approach to treating small and peripheral tumours, and a sutureless procedure is feasible in most cases. • This technique has a low complication rate and provides excellent functional outcome without impairing oncological results.
AB - OBJECTIVE: • To describe the technique and report the results of 'zero ischaemia', sutureless laparoscopic partial nephrectomy (LPN) for renal tumours with a low nephrometry score. PATIENTS AND METHODS: • Between August 2003 and January 2010, data from 101 consecutive patients who underwent 'zero ischaemia', sutureless LPN were collected in a prospectively maintained database. • Inclusion criteria were tumour size ≤ 4 cm, predominant exophytic growth and intraparenchymal depth ≤ 1.5 cm, with a minimum distance of 5 mm from the urinary collecting system. • Hilar vessels were not isolated, tumour dissection was performed with 10-mm LigaSure TM (Covidien, Boulder, CO, USA) and haemostasis was performed with coagulation and biological haemostatic agents without reconstructing the renal parenchyma. • Clinical, perioperative and follow-up data were collected prospectively, and modifications of functional outcome variables were analysed using the paired Wilcoxon test. RESULTS: • The median (range) tumour size was 2.4 (1.5-4) cm, and the median (range) intraparenchymal depth was 0.7 (0.4-1.4) cm. • Hilar clamping was not necessary in any patient, and suture was performed in four patients to ensure complete haemostasis. The median (range) operation duration was 60 (45-160) min, and median (range) intraoperative blood loss was 100 (20-240) mL. • Postoperative complications included fever (n = 4), low urinary output (n = 3) and haematoma, which was treated conservatively (n = 2). The median (range) hospital stay was 3 (2-5) days. The pathologist reported 30 benign tumours and renal cell carcinoma in 71 cases (pT1a in 69 patients, and pT1b in two patients). • At a median follow-up of 57 months, one patient underwent radical nephrectomy for ipsilateral recurrence. The 1-year median (range) decrease of split renal function at renal scintigraphy was 1 (0-5) %. CONCLUSIONS: • Zero ischaemia LPN is a reasonable approach to treating small and peripheral tumours, and a sutureless procedure is feasible in most cases. • This technique has a low complication rate and provides excellent functional outcome without impairing oncological results.
KW - Ischaemia
KW - Kidney neoplasms
KW - Kidney tumour
KW - Laparoscopy
KW - Partial nephrectomy
KW - Unclamped
UR - http://www.scopus.com/inward/record.url?scp=84862282211&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84862282211&partnerID=8YFLogxK
U2 - 10.1111/j.1464-410X.2011.10782,10797.x
DO - 10.1111/j.1464-410X.2011.10782,10797.x
M3 - Article
C2 - 22177008
AN - SCOPUS:84862282211
VL - 110
SP - 124
EP - 130
JO - BJU International
JF - BJU International
SN - 1464-4096
IS - 1
ER -