MP41-09 ASSESSMENT OF SURGICAL OUTCOMES OF THE NON-RENORRHAPHY TECHNIQUE IN OPEN PARTIAL NEPHRECTOMY FOR =T1B RENAL TUMORS

Abstract

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy I1 Apr 2016MP41-09 ASSESSMENT OF SURGICAL OUTCOMES OF THE NON-RENORRHAPHY TECHNIQUE IN OPEN PARTIAL NEPHRECTOMY FOR =T1B RENAL TUMORS Toshio Takagi, Tsunenori Kondo, Kenji Omae, Junpei Iizuka, Hirohito Kobayashi, Yasunobu Hashimoto, and Kazunari Tanabe Toshio TakagiToshio Takagi More articles by this author , Tsunenori KondoTsunenori Kondo More articles by this author , Kenji OmaeKenji Omae More articles by this author , Junpei IizukaJunpei Iizuka More articles by this author , Hirohito KobayashiHirohito Kobayashi More articles by this author , Yasunobu HashimotoYasunobu Hashimoto More articles by this author , and Kazunari TanabeKazunari Tanabe More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.176AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Renorrhaphy technique is a standard method to adapt renal parenchyma in partial nephrectomy (PN). However, adapting the renal parenchyma into a suitable shape without damaging vessels in cases of large renal tumors located at the renal hilum can be challenging, which has potential to reduce vascularized parenchymal mass. We assessed surgical outcomes between the non-renorrhaphy and renorrhaphy techniques in open partial nephrectomy for ≥ T1b renal tumors using volumetric studies. METHODS We retrospectively analyzed the records of 91 patients with normal contralateral kidneys who underwent both open PN for ≥T1b renal tumors and pre- and postoperative enhanced computed tomography between 2010 and 2014. Volumetric studies to assess vascularized parenchymal volume of the operated kidney were performed within 2 months preoperatively and 6 months postoperatively. Using the non-renorrhaphy technique, hemorrhagic areas on the surface of the renal parenchyma were coagulated by using monopolar soft-coagulation, while a TachoSil® tissue-sealing sheet was placed on the resected bed. RESULTS A total of 50 patients underwent renorrhaphy and 41 patients underwent non-renorrhaphy. Patient backgrounds and R.E.N.A.L Nephrometry scores were not significantly different between the two groups. Cold ischemia time was significantly longer in the renorrhaphy than in the non-renorrhaphy (52min vs. 42min, p=0.0162). However, significant differences were not observed in the preservation rate of the vascularized parenchymal mass in the operated kidney (renorrhaphy,71%:non-renorrhaphy,70%, p=0.5054) and global kidney function (renorrhaphy,88%: non-renorrhaphy,90%, p=0.3653) between the two groups. Age is the only predictor for global kidney function preservation (table). Renal artery pseudoaneurysm occurred in two cases in both groups. Urinary fistula tended to occur more frequently in non-renorrhaphy (2 cases) than in renorrhaphy (5 cases), though this difference was not statistically significant (p=0.237). CONCLUSIONS The non-renorrhaphy technique failed to show a benefit in the preservation of vascularized parenchymal mass of the operated kidney and global renal function for ≥T1b renal tumors compared to the renorrhaphy technique. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e563 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Toshio Takagi More articles by this author Tsunenori Kondo More articles by this author Kenji Omae More articles by this author Junpei Iizuka More articles by this author Hirohito Kobayashi More articles by this author Yasunobu Hashimoto More articles by this author Kazunari Tanabe More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...