Comparison of robot‐assisted partial nephrectomy with soft coagulation and double‐layer technique for complex and non‐complex tumors

Shiozaki, Keito; Izumi, Kazuyoshi; Sasaki, Yutaro; Kusuhara, Yoshito; Fukawa, Tomoya; Yamamoto, Yasuyo; Yamaguchi, Kunihisa; Ishikawa, Hirofumi; Takahashi, Masayuki; Kawanishi, Yasuo; Kanayama, Hiro‐omi

doi:10.1111/iju.15112

Cited by 5 publications

(4 citation statements)

References 30 publications

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“…In terms of the renorrhaphy method, no significant differences were noted in LOS, renal function, or incidence of postoperative complications, although SILR contributed to a reduction in operative time and WIT [26]. The operative time, console time, WIT, and LOS did not significantly differ according to the renorrhaphy method used; however, the incidence of urinary leakage or urinoma was significantly higher in the SILR group compared with in the DLR group [27]. One of the primary concerns related to SILR is the occurrence of postoperative complications, especially bleeding and urinary leakage [28].…”

Section: Discussionmentioning

confidence: 79%

“…Furthermore, multivariate analysis revealed that renorrhaphy was an independent predictor of renal volume loss after RAPN (p < 0.01) [10]. Another study demonstrated that patients who underwent SILR reported a shorter WIT and lower rate of worsening eGFR and renal volume at 4 months postoperatively compared with those who underwent DLR [27]. Renorrhaphy and the resulting traumatic lesions may be more crucial than the amount of tumor resected in predicting residual renal function after RAPN [6].…”

Section: Discussionmentioning

confidence: 99%

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Impact of Robotic-Assisted Partial Nephrectomy with Single Layer versus Double Layer Renorrhaphy on Postoperative Renal Function

Ito,

Nakane,

Hagiwara

et al. 2024

Current Oncology

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We aimed to investigate the differences in renal function between patients who underwent single inner-layer renorrhaphy (SILR) or double-layer renorrhaphy (DLR) among those with renal tumors who underwent robot-assisted partial nephrectomy (RAPN). This retrospective multicenter cohort study was conducted between November 2018 and October 2023 at two institutions and included patients who underwent RAPN. In total, 93 eligible patients who underwent RAPN were analyzed. Preoperative renal function and prevalence of chronic kidney disease were not significantly different between the two groups. Although urinary leakage was observed in three patients (5.9%) in the SILR group, there was no significant difference between the two groups regarding surgical outcomes (p = 0.249). Serum creatinine levels after RAPN were significantly lower in the SILR group than in the DLR group on postoperative days 1 and 365 following RAPN (p = 0.04). The estimated glomerular filtration rate (eGFR) was significantly lower in the DLR group than in the SILR group only on postoperative day 1; however, there was no significant difference between the two groups thereafter. Multivariate analysis showed that the method of renorrhaphy was not a predictor for maintaining renal function after RAPN even though it was associated with eGFR on postoperative day 1.

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Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Impact of Robotic-Assisted Partial Nephrectomy with Single Layer versus Double Layer Renorrhaphy on Postoperative Renal Function

Ito,

Nakane,

Hagiwara

et al. 2024

Current Oncology

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“…Kishore et al reported that single-layer cortical renorrhaphy is associated with a reduced rate of renal artery pseudoaneurysm compared to double-layer renorrhaphy 3 . In contrast, Shiozaki et al revealed that singlelayer suturing with soft coagulation achieved renal function and perioperative outcomes comparable to those of double-layer suturing regardless of tumor complexity 4 . Although these studies adjusted for patients or tumor backgrounds to compare surgical outcomes according to the reconstruction techniques, the surgeon's skill might not have been collectively adjusted because several surgeries were included in their studies.…”

Section: Introductionmentioning

confidence: 97%

“…Several techniques have been proposed to reconstruct the tumor bed after tumor resection, such as single-layer renorrhaphy, double-layer renorrhaphy, and sutureless coagulation of the bed. The optimal reconstruction methods have been discussed in terms of e cacy and feasibility [3][4][5][6] . Kishore et al reported that single-layer cortical renorrhaphy is associated with a reduced rate of renal artery pseudoaneurysm compared to double-layer renorrhaphy 3 .…”

Section: Introductionmentioning

confidence: 99%

Comparison of surgical outcomes of robot-assisted laparoscopic partial nephrectomy performed by a single experienced surgeon according to two reconstruction methods, including single-layer and double-layer renorrhaphy

Takagi,

Yoshida,

Fukuda

et al. 2024

Preprint

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Purpose: To compare surgical outcomes based on two reconstruction methods, including single-layer and double-layer renorrhaphy, in robot-assisted laparoscopic partial nephrectomy (RAPN) performed by an experienced surgeon. Methods: We included 655 patients who underwent RAPN between January 2019 and June 2023. Patients with multiple tumors or insufficient medical records were excluded; therefore, 554 patients were analyzed. Surgical outcomes were compared between single-layer renorrhaphy (outer cortical closure) and double-layer renorrhaphy (inner layer suture and outer cortical closure) after adjusting for the preoperative factors, such as sex, age, BMI, ASA score, preoperative eGFR, preoperative complications of diabetes or hypertension, surgical approach (transperitoneal or retroperitoneal), tumor size, and tumor complexity, using propensity score matching. Results: Of 554 patients, 59 were classified into the single-layer group and 495 into the double-layer group. Before matching, more complicated and larger tumors were included in the double-layer group. After matching, 58 patients were included in each group. The single-layer group showed significantly shorter operative time (91 min vs. 100 min, P=0.0361), lower EBL (7.9 ml vs. 27 ml, p=0.021), and better preservation of the eGFR (-1.2% vs. -5.1%, p=0.0313). Other outcomes, such as perioperative complications and postoperative hospital stay, were not significantly different between the two groups. Conclusions: This study revealed that single-layer reconstruction resulted in better surgical outcomes in terms of the operative time, EBL, and preservation of kidney function. Single-layer reconstruction may optimize RAPN in selected patients.

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Comparison of surgical outcomes of robot-assisted laparoscopic partial nephrectomy performed by a single experienced surgeon according to two reconstruction methods, including single-layer and double-layer renorrhaphy

Takagi,

Yoshida,

Fukuda

et al. 2024

J Robotic Surg

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Comparison of robot‐assisted partial nephrectomy with soft coagulation and double‐layer technique for complex and non‐complex tumors

Cited by 5 publications

References 30 publications

Impact of Robotic-Assisted Partial Nephrectomy with Single Layer versus Double Layer Renorrhaphy on Postoperative Renal Function

Impact of Robotic-Assisted Partial Nephrectomy with Single Layer versus Double Layer Renorrhaphy on Postoperative Renal Function

Comparison of surgical outcomes of robot-assisted laparoscopic partial nephrectomy performed by a single experienced surgeon according to two reconstruction methods, including single-layer and double-layer renorrhaphy

Comparison of surgical outcomes of robot-assisted laparoscopic partial nephrectomy performed by a single experienced surgeon according to two reconstruction methods, including single-layer and double-layer renorrhaphy

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