MP41-08 COMPARISON OF PERIOPERATIVE OUTCOMES WITH OR WITHOUT RENORRHAPHY IN OPEN PARTIAL NEPHRECTOMY: A PROPENSITY SCORE-MATCHED STUDY

Abstract

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy I1 Apr 2016MP41-08 COMPARISON OF PERIOPERATIVE OUTCOMES WITH OR WITHOUT RENORRHAPHY IN OPEN PARTIAL NEPHRECTOMY: A PROPENSITY SCORE-MATCHED STUDY Hidekazu Tachibana, Toshio Takagi, Junpei Iizuka, Tsunenori Kondo, and Kazunari Tanabe Hidekazu TachibanaHidekazu Tachibana More articles by this author , Toshio TakagiToshio Takagi More articles by this author , Junpei IizukaJunpei Iizuka More articles by this author , Tsunenori KondoTsunenori Kondo More articles by this author , and Kazunari TanabeKazunari Tanabe More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.175AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To preserve renal function after partial nephrectomy, various renorrhaphy techniques have been presented. However, any renorrhaphy technique may damage intraparenchymal vessels and compress the renal parenchyma, which may lead to renal artery pseudoaneurysm or vascularized parenchymal volume reduction. We therefore adopted a non-renorrhaphy technique in 2012 to avoid these issues. Using propensity score matching, we compared surgical outcomes of the non-renorrhaphy and renorrhaphy techniques for open partial nephrectomy for T1a renal tumors. METHODS We retrospectively analyzed data from 159 patients with normal contralateral kidneys who underwent open partial nephrectomy for T1a renal tumors and pre- and postoperative enhanced computed tomography between 2012 and 2015. Patient variables, including age, sex, body mass index, presence of hypertension and/or diabetes mellitus, performance status, tumor size, RENAL nephrometry score, and preoperative estimated glomerular filtration rate (eGFR), were adjusted using 1:1 propensity score matching between the renorrhaphy and non-renorrhaphy groups. For the renorrhaphy technique, we coagulated the surface of the resected renal parenchyma with monopolar soft coagulation after pressing a TachoSil tissue-sealing sheet on the resected bed for 10 minutes. RESULTS We matched 43 patients per group. Operative time, estimated blood loss, cold ischemic time, and postoperative hospital stay were not significantly different between the groups. Urine leakage occurred in 9 non-renorrhaphy cases and 1 renorrhaphy case (2.3% vs. 20%, P = 0.02). Renal artery pseudoaneurysm (RAP) occurred in 6 renorrhaphy cases but in 0 non-renorrhaphy cases (13% vs. 0%, P = 0.02). Postoperative eGFR decreased significantly less in the non-renorrhaphy group than in the renorrhaphy group (-11% vs. -1.5%, P = 0.04). CONCLUSIONS Despite the risk of urine leakage, the non-renorrhaphy technique compared to the renorrhaphy technique resulted in a lower risk of RAP and better preservation of eGFR for T1a renal tumors. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e562-e563 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Hidekazu Tachibana More articles by this author Toshio Takagi More articles by this author Junpei Iizuka More articles by this author Tsunenori Kondo More articles by this author Kazunari Tanabe More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...