Nephrectomy For Tumors Research Articles

Re: Partial Nephrectomy Versus Radical Nephrectomy for cT2 or Greater Renal Tumors: A Systematic Review and Meta-analysis

Re: Partial Nephrectomy Versus Radical Nephrectomy for cT2 or Greater Renal Tumors: A Systematic Review and Meta-analysis

SC3 - Predictors of positive surgical margins after robot-assisted partial nephrectomy for localized renal tumors: Insights from a large multicenter international prospective observational project (The Surface-Intermediate-Base Margin Score Consortium)

SC3 - Predictors of positive surgical margins after robot-assisted partial nephrectomy for localized renal tumors: Insights from a large multicenter international prospective observational project (The Surface-Intermediate-Base Margin Score Consortium)

SC59 - Perioperative complications after partial nephrectomy for complex renal tumors: A prospective multicenter observational study (RECORd 2 project)

SC59 - Perioperative complications after partial nephrectomy for complex renal tumors: A prospective multicenter observational study (RECORd 2 project)

SC50 - Renal artery embolization before radical nephrectomy for complex renal tumor: Which are the true advantages?

SC50 - Renal artery embolization before radical nephrectomy for complex renal tumor: Which are the true advantages?

Evaluation to Differentiate between Tumor Lesions and the Parenchyma in Partial Nephrectomies for Renal Tumors Based on Quantitative Fluorescence Imaging Using Indocyanine Green Dye

Introduction: Near-infrared fluorescence imaging with indocyanine green is a useful tool during partial nephrectomy. Because an accurate method for judging hasn't been established yet, the success rate may be slightly different and inconsistent. Materials and Methods: A total of 21 cases with suspected renal cancers who had undergone a partial nephrectomy were enrolled. We examined differences in the success rate between malignant lesions and the parenchyma by quantifying fluorescence in the pre-resection and ex vivo phases. Results: Pre-resection imaging showed a significant degradation of fluorescence in the focused lesion in 76.2% (16/21) of cases. A significant degradation was observed in 73.7% (14/19) of the total malignant lesions, 70.5% (12/17) of cases with a clear cell lesion, 100% (2/2) of cases with non-clear cell lesions, and 100% (2/2) of benign angiomyolipomas. In contrast, imaging of the ex vivo resected specimens showed a significant degradation in fluorescence of the focused lesions in 85.7% (18/21) of cases. A significantly degradation was observed in 84.2% (16/19) of the total malignant lesions, 82.3% (14/17) of cases with a clear cell lesion, 100% (2/2) of cases with non-clear cell lesions, and 100% (2/2) of benign angiomyolipomas. Conclusion: We firstly evaluated the efficacy of quantitative indocyanine green-based fluorescence as an objective method.

Impact of Curative Effect of Laparoscopic and Open Partial Nephrectomy for Complex Renal Tumours on Renal Function.

To explore the effect and safety of laparoscopic partial nephrectomy (LPN) and open partial nephrectomy (OPN) in the treatment of complex renal tumours and to compare renal function in the perioperative period. Comparative study. Departments of Urology and Cardiovascular Medicine, Affiliated Hospital of Hebei University, from July 2016 to June 2018. A total of 168 complex renal tumour patients with renal tumour scoring system scores (R.E.N.A.L) <7 and tumour stages of T1aN0M0~TlbN0M0 (diameter of tumour <7 cm without metastasis) were chosen. The patients were classified into the retroperitoneal laparoscopic partial nephrectomy (RLPN) group and open partial nephrectomy (OPN) group, comprising 84 patients in each group. Intraoperative and postoperative characteristics of both groups were compared. Statistical analysis of the occurrence rate of postoperative complications was conducted. Renal function indicators, including serum urea (UREA), creatinine (Cr), uric acid (UA) and glomerular filtration rate (GFR), were evaluated one day before the operation and one week after the operation. The differences between the two groups in intraoperative renal warm ischaemia time (WIT) and postoperative drainage time were not statistically significant. Compared with OPN group, RLPN group had shorter recovery time of gastrointestinal function, less use of analgesics and longer hospital stay. The difference in the recent occurrence rate of complications was not statistically significant. The differences between the two groups in UREA, Cr, UA and GFR one day before the operation and one week after the operation were not statistically significant (p>0.05). The Cr and UA levels of both groups improved significantly after the operation, and the GFR level declined significantly. The differences were statistically significant compared with preoperation levels (p<0.05). The effect and safety of RLPN in the treatment of complex renal tumours are equal to those of open operations. Laparoscopic surgery involves a small operative wound and contributes to renal function recovery, allowing patients to recover quickly; however, laparoscopic surgery has high technical requirements for its operators.

SC266 - Tumor contact surface area as predictor of postoperative complications and renal function in patients undergoing partial nephrectomy for renal tumors

SC266 - Tumor contact surface area as predictor of postoperative complications and renal function in patients undergoing partial nephrectomy for renal tumors

SC261 - Postoperative outcomes and two-year renal function in patients with limited life expectancy treated with partial nephrectomy for renal tumors: Analysis of predictors and comparison with patients with longer life expectancy (the record 2 project)

SC261 - Postoperative outcomes and two-year renal function in patients with limited life expectancy treated with partial nephrectomy for renal tumors: Analysis of predictors and comparison with patients with longer life expectancy (the record 2 project)

Heterogenous Renal Injury Biomarker Production Reveals Human Sepsis-Associated Acute Kidney Injury Subtypes.

Prospective, clinical laboratory study using "warm" human postmortem sepsis-acute kidney injury kidney biopsies. Research laboratory at university teaching hospital. Adult patients who died of sepsis in the ICU and control patients undergoing tumor nephrectomy. Reverse transcription quantitative polymerase chain reaction and immunohistochemical staining were used to quantify messenger RNA and protein expression levels of neutrophil gelatinase-associated lipocalin and kidney injury molecule-1 in the kidney of sepsis-acute kidney injury patients and control subjects. Morphometric analysis was used to quantify renal and glomerular neutrophil gelatinase-associated lipocalin and kidney injury molecule-1 protein levels. Neutrophil gelatinase-associated lipocalin and kidney injury molecule-1 messenger RNA and protein levels were increased in kidneys of sepsis-acute kidney injury patients compared with control kidney tissue. Neutrophil gelatinase-associated lipocalin was localized in the distal tubules, collecting ducts, the adventitia of the renal arterioles, and in the glomerular tufts of renal biopsies from sepsis-acute kidney injury patients. In contrast, kidney injury molecule-1 was localized at the brush border of the proximal tubules. There was no correlation between neutrophil gelatinase-associated lipocalin and kidney injury molecule-1 levels. Furthermore, renal neutrophil gelatinase-associated lipocalin and kidney injury molecule-1 levels were not associated with the extent of renal injury, the severity of critical illness, or serum creatinine levels at either ICU admission or day of expiration. By laser microdissecting glomeruli, followed by reverse transcription quantitative polymerase chain reaction, we identified heterogenous glomerular neutrophil gelatinase-associated lipocalin production in the kidney of sepsis-acute kidney injury patients. We found differences in the expression of neutrophil gelatinase-associated lipocalin and kidney injury molecule-1 in patients with the same syndrome "sepsis-acute kidney injury" meaning there is no single pathway leading to sepsis-acute kidney injury. This underscores the beliefs that there are many/different pathophysiological pathways that can cause sepsis-acute kidney injury. Hence, patients with criteria that meet the definitions of both acute kidney injury and sepsis can be divided into subtypes based on pathophysiological features.

The role of three-dimensional reconstruction in laparoscopic partial nephrectomy for complex renal tumors

BackgroundTo evaluate the role of three-dimensional (3D) reconstruction technique in renal function protection and ipsilateral parenchymal mass preserved after laparoscopic partial nephrectomy (LPN) in patients with complex renal tumor (R.E.N.A.L.score ≥ 8).MethodsA retrospective study enrolling 49 patients who suffered from RCC and underwent LPN at our center, from October 1, 2017, to October 31, 2018. Twenty-one patients (group A) underwent LPN with the 3D reconstruction technique before surgery, and the other 28 patients (group B) not. Preoperative and postoperative ipsilateral parenchymal mass volume and ipsilateral glomerular filtration rate (GFR) were analyzed 3–5 days prior and 3 months after PN. In order to compare the two groups, Mann-Whitney U test and chi-square tests were performed. The main limitation of this technique is that the volume calculations are partly performed manually.ResultsAll patients’ median renal score was 10 with no difference between the two groups (P = 0.89), and the median tumor size of the two groups was 3.2 cm (group A) and 3.3 cm (group B) respectively (P = 0.14). In addition, the median warm ischemia time of the two groups was 21 min (group A) and 26 min (group B) (P = 0.003). In group A and group B, the rate of preserved global GFR was 88% and 86% (P = 0.06), preserved ipsilateral GFR was 80% and 77% (P = 0.01), and preserved ipsilateral parenchymal was 84% and 80% (P = 0.03) separately.Conclusion3D reconstruction technique was a beneficial method for more renal function and more preserved renal parenchymal mass volume after LPN.Trial registrationYantai Yuhuangding Hospital, YHD[2017]212. Registered 1 January 2017 (prospectively registered), http://www.ytyhdyy.com/nav/103.htm.

PE42 - Robotic partial nephrectomy for clinical stage T1 tumors: Experience in 165 cases

PE42 - Robotic partial nephrectomy for clinical stage T1 tumors: Experience in 165 cases

VE10 - Robotic assisted partial nephrectomy for T2 tumour

VE10 - Robotic assisted partial nephrectomy for T2 tumour

PE52 - Minimally invasive partial nephrectomy in cT2a renal tumors: Oncological outcomes in a tertiary center

PE52 - Minimally invasive partial nephrectomy in cT2a renal tumors: Oncological outcomes in a tertiary center

PE43 - Robotic assisted partial nephrectomy for T2 renal tumours

PE43 - Robotic assisted partial nephrectomy for T2 renal tumours

Da Vinci Xi robotic partial nephrectomy for complex renal tumours: step by step approach of trans-peritoneal and retro-peritoneal technique

Da Vinci Xi robotic partial nephrectomy for complex renal tumours: step by step approach of trans-peritoneal and retro-peritoneal technique

VE14 - Robotic partial nephrectomy for complex hilar tumors: Tips & tricks

VE14 - Robotic partial nephrectomy for complex hilar tumors: Tips & tricks

Laparoendoscopic single-site nephrectomy versus conventional laparoendoscopic nephrectomy for kidney tumor: a systematic review and meta-analysis.

With the increasing application of laparoendoscopic single-site nephrectomy (LESS-N) in kidney tumor, accumulating studies compared it with conventional laparoendoscopic nephrectomy (CL-N). However, controversial outcomes were reported. Hence, this meta-analysis was carried out to clarify these issues. Online databases PubMed, EMBASE and the Cochrane Library were searched comprehensively for eligible studies published before 24 July 2018. Odds ratios (ORs) or standardized mean differences (SMDs) with corresponding 95% confidence intervals (CIs) were collected for evaluating the pooled results of relevant outcomes. Ultimately, 13 eligible articles were enrolled. Meanwhile, compared with CL-N, LESS-N was related to a longer operation time (SMD: 0.40; 95% CI, 0.23–0.58; P=0.000), a shorter length of hospital stay (LOS) (SMD: −0.32; 95% CI, −0.62 to −0.02; P=0.034), a lower visual analog scale (VAS) score (SMD: −0.89; 95% CI, −1.22 to −0.56; P=0.000) and a lower analgesic requirement (SMD: −0.55; 95% CI, −0.87 to −0.23; P=0.001). There was no statistical difference in the postoperative day of oral intake, estimated blood loss (EBL), conversion rate, perioperative complications, intraoperative complications, postoperative complications, minor complications and major complications between LESS-N and CL-N. Patients with LESS-N for kidney tumor could have a longer operation time and shorter LOS, and meanwhile could need less analgesics and suffer less pain after LESS-N.

Superselective transcatheter arterial embolization to control renal hemorrhage after partial nephrectomy for renal tumors: A report of 9 cases and a literature review

ObjectiveThis study aimed to evaluate the efficacy and safety of selective arterial embolization for hemorrhage after renal surgery and to summarize the clinical experience. Materials and methodsA total of 9 patients underwent arterial embolization after partial nephrectomy from 2010 to 2018. ResultsTechnical success was achieved in all patients; however, 3 patients underwent a secondary arterial embolization because of short-term re-hemorrhage or the co-occurrence of accessory renal arterial hemorrhage. No serious complications occurred during the follow-up. ConclusionsSuperselective arterial embolization is an effective and minimally invasive treatment for hemorrhage after partial nephrectomy. To improve the success rate of surgery, attention should be paid to the evaluation of accessory renal arteries and the management of suspected bleeding arteries.

SAT-336 Non-Neoplastic Renal Diseases Are Common and Underdiagnosed in Nephroureterectomy Specimens

The relationship between chronic kidney disease and renal malignancies is increasingly being recognized. Non-neoplastic kidney diseases can be diagnosed in up to 15% of tumor nephrectomy specimens from kidney cancer patients. We conducted this study to evaluate the non-neoplastic renal parenchyma of nephroureterectomy specimens of urothelial neoplasia of the renal pelvis.

Small renal masses. Analysis of 152 cases

Small renal masses (SRM) are defined as complex organ-confined solid or cystic lesions < 4 cm. Up to 20% of these can be benign. A conservative management with active surveillance can be done in some patients. However, it is difficult to identify patients with a higher risk of malignancy. To characterize the clinical, radiological and histopathological aspects of patients with SRM, analyzing predictive factors for tumor aggressiveness. Retrospective analysis of a cohort of patients undergoing partial or total nephrectomy for renal tumors between 2006 and 2016. All tumors of 4 cm or less were included. Four histological groups were defined: benign, favorable, intermediate and unfavorable. Two categories of risk were also defined: low and high. Preoperative clinical and radiological variables of these patients were analyzed. Data of 152 patients were analyzed. Six percent had a benign histology, and the majority was of intermediate risk (74%). According to histological type, clear cell carcinoma was the most common type (74%). Three percent were benign angiomyolipomas. No malignancy predictive variable was identified. In these patients, the percentage of benign SRM was low. No variable that could predict the presence of a benign or malignant lesion in the definitive biopsy was identified.