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4 results on '"Robot-assisted partial nephrectomy"'

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Author

AOKI, Takahiro, WADA, Naoki, TAMAKI, Gaku, ABE, Noriyuki, KOBAYASHI, Shin, MIYAUCHI, Kotona, ISHIKAWA, Mayumi, MAKINO, Shogo, NAGABUCHI, Masaya, KAKIZAKI, Hidehiro, AOKI, Takahiro, WADA, Naoki, TAMAKI, Gaku, ABE, Noriyuki, KOBAYASHI, Shin, MIYAUCHI, Kotona, ISHIKAWA, Mayumi, MAKINO, Shogo, NAGABUCHI, Masaya, and KAKIZAKI, Hidehiro

Abstract

We investigated pre-operative factors affecting trifecta achievement in robot-assisted partial nephrectomy (RAPN). We retrospectively analyzed 81 patients who underwent RAPN from December 2016 to September 2021 with final malignant pathologies. Trifecta was defined as negative resection margin (RM), warm ischemic time (WIT) less than 25 minutes, and no severe perioperative complications (Clavien-Dindo＜III). Factors affecting trifecta achievement were analyzed using sex, age, body mass index, RENAL nephrometry score (low or moderate/high complexity), surgical approach (transabdominal or retroperitoneal), tumor diameter and surgical experiences of each surgeon. Negative RM, WIT less than 25 minutes, and no severe complications were obtained in 75 (93%), 65 (80%), and 79 patients (98%), respectively. The trifecta was achieved in 60 patients (74%). In multivariate regression analysis, surgical experience (OR:0.92, 95% CI : 0.86-0.99) was significantly associated with trifecta achievement. Receiver operating characteristic curve analysis identified 9 cases as the optimal cut-off values for the predication of trifecta achievement (AUC＝0.69, p ＝0.11). The achievement of WIT less than 25 minutes (65 vs 90%, p＜0.01) and trifecta (58 vs 84%, p ＜0.05) were significantly lower in surgical experiences less than 9 cases than in 9 or greater. We conclude that surgical experience in RAPN is an important factor affecting WIT and trifecta achievement in the initial series.

Published
2023

2. Outcomes of robot-assisted partial nephrectomy in the treatment of renal cell carcinoma at Kawasaki Medical School Hospital

Author

FUJII, Tomohiro, MIYAJI, Yoshiyuki, OHIRA, Shin, MORINAKA, Hirofumi, SUGIYAMA, Seitetsu, FUJITA, Masaichiro, SHIMIZU, Shinjiro, TSUKIMORI, Syohei, KAIFU, Mikako, HARA, Ryoei, NAGAI, Atsushi, FUJII, Tomohiro, MIYAJI, Yoshiyuki, OHIRA, Shin, MORINAKA, Hirofumi, SUGIYAMA, Seitetsu, FUJITA, Masaichiro, SHIMIZU, Shinjiro, TSUKIMORI, Syohei, KAIFU, Mikako, HARA, Ryoei, and NAGAI, Atsushi

Abstract

type:Regular Article, source:https://igakkai.kms-igakkai.com/wp/wp-content/uploads/2020en/KMJ-E202046027.pdf

Published
2021

3. Nomogram for predicting the likelihood of postoperative surgical complications in patients treated with partial nephrectomy: a prospective multicentre observational study (the RECORd 2 project)

Author

Mari, A, Campi, R, Schiavina, R, Amparore, D, Antonelli, A, Artibani, W, Barale, M, Bertini, R, Borghesi, M, Bove, P, Brunocilla, E, Capitanio, U, Da Pozzo, L, Daja, J, Gontero, P, Larcher, A, Li Marzi, V, Longo, N, Mirone, V, Montanari, E, Pisano, F, Porpiglia, F, Simeone, C, Siracusano, S, Tellini, R, Trombetta, C, Volpe, A, Ficarra, V, Carini, M, Minervini, A, Altieri, V, Berardinelli, F, Celia, A, Costantini, E, Di Maida, F, Falsaperla, M, Fiori, C, Furlan, M, Marson, F, Montorsi, F, Morgia, G, Porreca, A, Roscigno, M, Schips, L, Selli, C, Simonato, A, Terrone, C, Vespasiani, G, Villari, D, Mari A., Campi R., Schiavina R., Amparore D., Antonelli A., Artibani W., Barale M., Bertini R., Borghesi M., Bove P., Brunocilla E., Capitanio U., Da Pozzo L., Daja J., Gontero P., Larcher A., Li Marzi V., Longo N., Mirone V., Montanari E., Pisano F., Porpiglia F., Simeone C., Siracusano S., Tellini R., Trombetta C., Volpe A., Ficarra V., Carini M., Minervini A., Altieri V., Berardinelli F., Celia A., Costantini E., Di Maida F., Falsaperla M., Fiori C., Furlan M., Marson F., Montorsi F., Morgia G., Porreca A., Roscigno M., Schips L., Selli C., Simonato A., Terrone C., Vespasiani G., Villari D., Mari, A, Campi, R, Schiavina, R, Amparore, D, Antonelli, A, Artibani, W, Barale, M, Bertini, R, Borghesi, M, Bove, P, Brunocilla, E, Capitanio, U, Da Pozzo, L, Daja, J, Gontero, P, Larcher, A, Li Marzi, V, Longo, N, Mirone, V, Montanari, E, Pisano, F, Porpiglia, F, Simeone, C, Siracusano, S, Tellini, R, Trombetta, C, Volpe, A, Ficarra, V, Carini, M, Minervini, A, Altieri, V, Berardinelli, F, Celia, A, Costantini, E, Di Maida, F, Falsaperla, M, Fiori, C, Furlan, M, Marson, F, Montorsi, F, Morgia, G, Porreca, A, Roscigno, M, Schips, L, Selli, C, Simonato, A, Terrone, C, Vespasiani, G, Villari, D, Mari A., Campi R., Schiavina R., Amparore D., Antonelli A., Artibani W., Barale M., Bertini R., Borghesi M., Bove P., Brunocilla E., Capitanio U., Da Pozzo L., Daja J., Gontero P., Larcher A., Li Marzi V., Longo N., Mirone V., Montanari E., Pisano F., Porpiglia F., Simeone C., Siracusano S., Tellini R., Trombetta C., Volpe A., Ficarra V., Carini M., Minervini A., Altieri V., Berardinelli F., Celia A., Costantini E., Di Maida F., Falsaperla M., Fiori C., Furlan M., Marson F., Montorsi F., Morgia G., Porreca A., Roscigno M., Schips L., Selli C., Simonato A., Terrone C., Vespasiani G., and Villari D.

Abstract

Objective: To identify meaningful predictors and to develop a nomogram of postoperative surgical complications in patients treated with partial nephrectomy (PN). Patients and Methods: We prospectively evaluated 4308 consecutive patients who had surgical treatment for renal tumours, between 2013 and 2016, at 26 Italian urological centres (RECORd 2 project). A multivariable logistic regression for surgical complications was performed. A nomogram was created from the multivariable model. Internal validation processes were performed using bootstrapping with 1000 repetitions. Results: Overall, 2584 patients who underwent PN were evaluated for the final analyses. The median (interquartile [IQR]) American Society of Anesthesiologists (ASA) score was 2 (2–3). In all, 72.4% of patients had clinical T1a (cT1a) stage tumours. The median (IQR) Preoperative Aspects and Dimensions Used for an Anatomical (PADUA) score was 7 (6–8). Overall, 34.3%, 27.7%, 38% of patients underwent open PN (OPN), laparoscopic PN (LPN), and robot-assisted PN (RAPN). Overall and major postoperative surgical complications were recorded in 10.2% and 2.5% of patients, respectively. At multivariable analysis, age, ASA score, cT2 vs cT1a stage, PADUA score, preoperative anaemia, OPN and LPN vs RAPN, were significant predictive factors of postoperative surgical complications. We used these variables to construct a nomogram for predicting the risk of postoperative surgical complications. At decision curve analysis, the nomogram led to superior outcomes for any decision associated with a threshold probability of >5%. Conclusion: Several clinical predictors have been associated with postoperative surgical complications after PN. We used this information to develop and internally validate a nomogram to predict such risk.

Published
2019

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