Functional and oncological outcomes of 3D clampless sutureless laparoscopic partial nephrectomy for renal tumors with low nephrometry score

Introini, Carlo; Domenico, Antonia Di; Ennas, Marco; Campodonico, Fabio; Brusasco, Claudia; Benelli, Andrea

doi:10.23736/s0393-2249.20.04005-9

Cited by 12 publications

(3 citation statements)

References 30 publications

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“…Sutureless PN, which reduces technical burden by eliminating the need for renorrhaphy, is worthy of further research and development. Although several studies ( 8 – 13 , 35 , 36 ) have reported the feasibility of off-clamp sutureless PNs, these techniques limit the targets to small and low-complexity renal tumors. Brassetti et al ( 36 ) demonstrated that the sutureless approach significantly increases trifecta achievement (negative surgical margin, no major complications, and no significant RF deterioration) compared to renorrhaphy in off-clamp robotic PN.…”

Section: Discussionmentioning

confidence: 99%

Comparison of off-clamp microwave scissors-based sutureless partial nephrectomy versus on-clamp conventional partial nephrectomy in a canine model

Nguyen,

Yamada,

Naka

et al. 2023

Front. Surg.

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ObjectivesTo compare the usefulness and safety of off-clamp microwave scissors-based sutureless partial nephrectomy (MSPN) with on-clamp conventional partial nephrectomy (cPN) in dogs.MethodsWe performed off-clamp MSPN using microwave scissors (MWS) in six dogs, and on-clamp cPN in three dogs, in two-stage experiments. The bilateral kidney upper poles were resected via a midline incision under general anesthesia. After 14 days of follow-up, the lower pole resections were performed. The renal calyces exposed during renal resections were sealed and transected using MWS in off-clamp MSPN and were sutured in on-clamp cPN. In the off-clamp MSPN group, the generator's power output of MWS was set as either 50 W or 60 W for each kidney side. We compared the procedure time (PT), ischemic time (IT), blood loss (BL), and normal nephron loss (NNL) between the two techniques using the Mann–Whitney U-test.ResultsWe successfully performed 24 off-clamp MSPNs and 12 on-clamp cPNs. The off-clamp MSPN was significantly superior to on-clamp cPN in avoiding renal ischemia (median IT, 0 min vs. 8.6 min, p < 0.001) and reducing PT (median PT, 5.8 min vs. 11.5 min, p < 0.001) and NNL (median NNL, 5.3 mm vs. 6.0 mm, p = 0.006) with comparable BL (median BL, 20.9 ml vs. 23.2 ml, p = 0.804). No bleeding and major urine leakage were noted during the reoperations.ConclusionsOff-clamp MSPN outperforms on-clamp cPN in lowering the risks of postoperative renal function impairment in dogs.

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Section: Discussionmentioning

confidence: 99%

Comparison of off-clamp microwave scissors-based sutureless partial nephrectomy versus on-clamp conventional partial nephrectomy in a canine model

Nguyen,

Yamada,

Naka

et al. 2023

Front. Surg.

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“…Two-layer suturing is a reliable suture procedure during LPN, which contains the inner layer to suture the base and the outer layer to suture the edge of renal parenchyma (12). Besides, such a suture method involves a clamp for the renal artery, creating reduced blood flow, and decreased risks of intraoperative hemorrhage (13,14). However, compared with the single-layer suture, there was a longer clamping time, WIT duration, and operative time in the two-layer suture method.…”

Section: Introductionmentioning

confidence: 99%

A Modified Two-Layer Suture Technique for Transperitoneal Laparoscopic Partial Nephrectomy: Single-Center Clinical Experience

et al. 2022

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PurposesThis study aims to evaluate the feasibility and efficacy of a modified two-layer suture method during laparoscopic partial nephrectomy (LPN) by a comparative analysis with the traditional two-layer suture.MethodsA total of 60 LPN patients were enrolled in this study, of which 30 patients received the modified two-layer suture method and the remaining 30 patients underwent the traditional two-layer suture. Then, surgical characteristics including operative time, warm ischemic time (WIT), estimated blood loss (EBL), and glomerular filtration rate (GFR) were recorded. Finally, univariable and multivariable linear regression analyses were used to evaluate the correlations of tumor characteristics, suture methods, and postoperative renal function.ResultsThere was no significant difference between the two suture groups with respect to patient and tumor characteristics, postoperative creatinine level, and blood urea nitrogen (BUN) level. The modified suture group showed a significantly shorter clamping time and a less GFR level reduction than the traditional two-layer suture group (15 vs. 23 min; 42.32 ± 9.48 vs. 27.07 ± 7.88; p < 0.05). Additionally, the modified two-layer suture was an independent factor that influenced the clamping time and the level of GFR reduction.ConclusionThe modified two-layer suture method is feasible and effective for LPN.

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“…Second, in this study we just wanted to investigate how the use of 3D can influence the success of the procedure in its whole, also focusing on complications, according to definition of margins, ischemia and complications [ 4 ]. In this achievement we acknowledge to be the first.…”

mentioning

confidence: 99%

Reply to Grange PC, Morris PT, Benz HL, Buggele WA, Fryrear RS. Letter to the editor re: Amparore D, Pecoraro A, Piramide F, Verri P, Checcucci E, De Cillis S, et al. Three-dimensional imaging reconstruction of the kidney's anatomy for a tailored minimally invasive partial nephrectomy: A pilot study. Asian J Urol 2022;9:263–71. A further step towards personalized surgery through virtual clip application

Pecoraro

2023

Asian Journal of Urology

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Functional and oncological outcomes of 3D clampless sutureless laparoscopic partial nephrectomy for renal tumors with low nephrometry score

Cited by 12 publications

References 30 publications

Comparison of off-clamp microwave scissors-based sutureless partial nephrectomy versus on-clamp conventional partial nephrectomy in a canine model

Comparison of off-clamp microwave scissors-based sutureless partial nephrectomy versus on-clamp conventional partial nephrectomy in a canine model

A Modified Two-Layer Suture Technique for Transperitoneal Laparoscopic Partial Nephrectomy: Single-Center Clinical Experience

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