V5-07 A NOVEL TECHNIQUE OF NON-TISSUE SUTURING LAPAROSCOPIC PARTIAL NEPHRECTOMY WITHOUT THE RENORRHAPHY

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You have accessJournal of UrologyRenal Oncology1 Apr 2016V5-07 A NOVEL TECHNIQUE OF NON-TISSUE SUTURING LAPAROSCOPIC PARTIAL NEPHRECTOMY WITHOUT THE RENORRHAPHY Nobuyuki Fukuzawa, Hiroshi Tanaka, Madoka Higuchi, Hidetaka Suzuki, Ai Kawaguchi, Shintaro Maru, Tomoshige Akino, Yoshiki Wada, Hiroshi Harada, and Toshimori Seki Nobuyuki FukuzawaNobuyuki Fukuzawa More articles by this author , Hiroshi TanakaHiroshi Tanaka More articles by this author , Madoka HiguchiMadoka Higuchi More articles by this author , Hidetaka SuzukiHidetaka Suzuki More articles by this author , Ai KawaguchiAi Kawaguchi More articles by this author , Shintaro MaruShintaro Maru More articles by this author , Tomoshige AkinoTomoshige Akino More articles by this author , Yoshiki WadaYoshiki Wada More articles by this author , Hiroshi HaradaHiroshi Harada More articles by this author , and Toshimori SekiToshimori Seki More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.250AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Laparoscopic partial nephrectomy (LPN) has been commonly performed to spare as much as nephron mass, however, renal ischemic time is problematic. Furthermore, conventional suturing technique has potential to produce post-operative pseudo aneurysm and subsequent abrupt bleeding. We introduced a novel non-tissue suturing laparoscopic partial nephrectomy (NTS-LPN) and compared clinical outcomes with conventional laparoscopic partial nephrectomy (C-LPN) in our institution. METHODS A hundred-eighty five patients who underwent partial nephrectomy since 2004 were divided between NTS-LPN group (NTS) (n=98) and C-LPN group (C) (n=87). The surgical maneuver of NTS differs with C after excising tumor with renal artery clamping. The resected surface was simply coagulated using a soft-coagulation system (a VIOTM system and an IO electrodeTM) without parenchyma suturing. After declamping, a TachoSil® is attached on coagulated surface. Perioperative data including the parenchymal volume of postoperative renal ischemic volume (PRIV) and the change of residual renal volume (RRV) calculated by 3D-CT volumetry, postoperative kidney function and adverse events were compared between 2 groups. RESULTS Mean operative time and renal ischemic time in NTS (146±34.0min/15.6±7.45min) were dramatically shortened as compared to those in C (236±77.8min/54.8±27.4min). Mean operative blood loss was similar between NTS (43.3±61.5ml) and C (65.9±91.9ml). Renal parenchymal damage as shown PRIV was significantly less in NTS group than that in C at the point of postoperative 3, 6, 12 months (NTS: 4.26±2.29ml, 2.37±1.02ml, 1.67±0.55ml / C: 19.4±5.49ml, 15.9±8.20ml, 13.1±6.00ml). Renal atrophy as shown RRV postoperative 3, 6, 12 months was also significantly less in NTS than that in C (p<0.01). No positive surgical margin was observed in NTS, but only one case in C. Serum creatinine values of each point (1/3/6/12 months) were comparable in both groups. According to Clavien-Dindo classification, major complications of IIIa (postoperative bleeding, minor urinary leakage and peri-renal abscess) were observed in C, whereas 2 cases of minor urinary leakage in NTS. In addition, 6 cases of pseudo aneurysm were only observed in C. CONCLUSIONS A novel technique of NTS-LPS could spare operative and ischemic time and nephron loss as well without increasing invasiveness compared with conventional tissue-suturing partial nephrectomy. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e595-e596 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Nobuyuki Fukuzawa More articles by this author Hiroshi Tanaka More articles by this author Madoka Higuchi More articles by this author Hidetaka Suzuki More articles by this author Ai Kawaguchi More articles by this author Shintaro Maru More articles by this author Tomoshige Akino More articles by this author Yoshiki Wada More articles by this author Hiroshi Harada More articles by this author Toshimori Seki More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...