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Outcomes of gasless laparoendoscopic singleāport partial nephrectomy in 356 consecutive patients: Feasibility of a clampless and sutureless technique
- Source :
- International Journal of Urology. 28:302-307
- Publication Year :
- 2020
- Publisher :
- Wiley, 2020.
-
Abstract
- Objectives To investigate the outcomes and feasibilities of gasless laparoendoscopic single-port clampless sutureless partial nephrectomy. Methods We reviewed 356 consecutive patients with primary unilateral non-metastatic renal masses who underwent gasless laparoendoscopic single-port partial nephrectomy (2011-2018), which was performed retroperitoneally using a three-dimensional flexible endoscope, without vascular clamping or renorrhaphy in principle. Results The median tumor size was 2.5 cm, and 213 (60%), 105 (29%), and 38 (11%) patients had peripheral, central, and hilar tumors, respectively. Clampless and sutureless partial nephrectomy was accomplished in 337 patients (95%), while eight (2%) and 16 (4%) patients required vascular clamping and renorrhaphy, respectively. The median operative time and blood loss were 220 min and 266 mL, respectively; eight patients (2%) received blood transfusion. Clavien-Dindo grade 3a complications occurred in 27 patients (8%); all these patients had urinary leakage treated with ureteral stent placement, one of whom also developed a postoperative pseudoaneurysm. Among 324 patients diagnosed with renal cell carcinoma, six (2%) had positive surgical margins, and one (0.3%) and seven (2%) developed metastatic and local recurrences, respectively. During a median follow-up of 54 months, no patient died from kidney cancer. The median percent decrease in estimated glomerular filtration rate at 3 months after surgery was 5.7%. No patient experienced postoperative acute renal failure, while one patient with preexisting renal impairment started dialysis at 70 months after surgery. Conclusions Clampless and sutureless partial nephrectomy can be safely accomplished in most patients undergoing gasless laparoendoscopic single-port surgery, yielding favorable oncological and functional outcomes.
- Subjects :
- medicine.medical_specialty
Blood transfusion
Urology
medicine.medical_treatment
030232 urology & nephrology
Renal function
Nephrectomy
03 medical and health sciences
Pseudoaneurysm
0302 clinical medicine
Renal cell carcinoma
medicine
Humans
Dialysis
Retrospective Studies
business.industry
medicine.disease
Kidney Neoplasms
Surgery
Treatment Outcome
030220 oncology & carcinogenesis
Feasibility Studies
Laparoscopy
Neoplasm Recurrence, Local
Positive Surgical Margin
business
Kidney cancer
Subjects
Details
- ISSN :
- 14422042 and 09198172
- Volume :
- 28
- Database :
- OpenAIRE
- Journal :
- International Journal of Urology
- Accession number :
- edsair.doi.dedup.....6b4f12928c71cf72f1b820df13ed6d43
- Full Text :
- https://doi.org/10.1111/iju.14452