Imaging Features of Renal Masses to Select Optimal Candidates for Tumor Enucleation Partial Nephrectomy

Desai, Shalin; Rac, Goran; Patel, Hiten D.; Gupta, Gopal N.

doi:10.1007/s11934-022-01121-w

Cited by 3 publications

(2 citation statements)

References 72 publications

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“…The use of tumor enucleation was principally limited to patients with a definitive tumor pseudocapsule on pre-operative MRI and who have appropriately staged lesions without areas of subtle concern for invasion of the perinephric fat or evidence of local or vascular invasion. 20 Nonetheless, the data presented here adds to the literature further evidence that the RP approach is another viable option in the armamentarium of urologic surgeons in the treatment of localized renal cancer even for anterior kidney lesions.…”

Section: Discussionmentioning

confidence: 58%

Robotic transperitoneal versus retroperitoneal approach for anterior renal mass nephron-sparing surgery

Lanzotti,

Felice,

Janakiraman

et al. 2024

J Robotic Surg

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Introduction Robotic nephron-sparing surgery is traditionally performed via a transperitoneal (TP) approach. However, the retroperitoneal (RP) approach has gained popularity, particularly for posterolateral renal masses. The RP approach is associated with shorter operative time, less blood loss, and shorter length of stay, while preserving oncologic outcomes in selected masses. Here, we aim to assess the feasibility of the RP approach in excising anterior renal masses. Methods Patients ≥18 years of age who underwent robotic nephron-sparing surgery for anterior renal masses were retrospectively identified (2008–2022). Baseline demographics, tumor characteristics, and peri-operative data were collected and characterized based on TP vs RP approaches. Wilcoxon rank sum test and Pearson’s chi-squared test were used to compare continuous and categorical variables, respectively. Results 216 patients were included – 178 (82.4%) underwent TP approach and 38 (17.6%) underwent RP approach. Baseline demographics, preoperative tumor size,_and renal nephrometry scores were similar. The RP approach was associated with shorter operative (150 vs 203 min, p<0.001) and warm ischemia time (12 vs 21 min, p<0.001), and less blood loss (20 vs 100 cc, p=0.002) ( Table 1 ). The RP approach was associated with shorter length of stay (1 vs 2 days, p<0.001) and less total complications (5.3% vs 19.1%, p=0.038). Major complication (Clavien-Dindo Grade ≥3) rates were similar. There was no difference in positive surgical margin rates or pathologic characteristics. Conclusions Robotic RP approach for nephron-sparing surgery is feasible for eligible anterior tumors and is associated with favorable perioperative outcomes with preserved negative surgical margin rates.

show abstract

Section: Discussionmentioning

confidence: 58%

Robotic transperitoneal versus retroperitoneal approach for anterior renal mass nephron-sparing surgery

Lanzotti,

Felice,

Janakiraman

et al. 2024

J Robotic Surg

Self Cite

View full text Add to dashboard Cite

show abstract

“…The use of tumor enucleation was principally limited to patients with a de nitive tumor pseudocapsule on pre-operative MRI and who have appropriately staged lesions without areas of subtle concern for invasion of the perinephric fat or evidence of local or vascular invasion. 20 Nonetheless, the data presented here adds to the literature further evidence that the RP approach is another viable option in the armamentarium of urologic surgeons in the treatment of localized renal cancer even for anterior kidney lesions.…”

Section: Discussionmentioning

confidence: 58%

Robotic transperitoneal versus retroperitoneal approach for anterior renal mass nephron-sparing surgery

Lanzotti,

Felice,

Janakiraman

et al. 2023

Preprint

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Introduction Robotic nephron-sparing surgery is traditionally performed via a transperitoneal (TP) approach. However, the retroperitoneal (RP) approach has gained popularity, particularly for posterolateral renal masses. The RP approach is associated with shorter operative time, less blood loss, and shorter length of stay, while preserving oncologic outcomes in selected masses. Here, we aim to assess the feasibility of the RP approach in excising anterior renal masses. Methods Patients ≥18 years of age who underwent robotic nephron-sparing surgery for anterior renal masses were retrospectively identified (2008-2022). Baseline demographics, tumor characteristics, and peri-operative data were collected and characterized based on TP vs RP approaches. Wilcoxon rank sum test and Pearson’s chi-squared test were used to compare continuous and categorical variables, respectively. Results 216 patients were included – 178 (82.4%) underwent TP approach and 38 (17.6%) underwent RP approach. Baseline demographics, preoperative tumor size, and renal nephrometry scores were similar. The RP approach was associated with shorter operative (150 vs 203 min, p<0.001) and warm ischemia time (12 vs 21 min, p<0.001), and less blood loss (20 vs 100 cc, p=0.002) (Table 1). The RP approach was associated with shorter length of stay (1 vs 2 days, p<0.001) and less total complications (5.3% vs 19.1%, p=0.038). Major complication (Clavien-Dindo Grade >3) rates were similar. There was no difference in positive surgical margin rates or pathologic characteristics. Conclusions Robotic RP approach for nephron-sparing surgery is feasible for eligible anterior tumors and is associated with favorable perioperative outcomes with preserved negative surgical margin rates.

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Risk of pseudoaneurysm and bleeding complications after partial nephrectomy: comparison of tumor enucleation to standard margin technique

Rac,

Ellis,

Janakiraman

et al. 2024

J Robotic Surg

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Imaging Features of Renal Masses to Select Optimal Candidates for Tumor Enucleation Partial Nephrectomy

Cited by 3 publications

References 72 publications

Robotic transperitoneal versus retroperitoneal approach for anterior renal mass nephron-sparing surgery

Robotic transperitoneal versus retroperitoneal approach for anterior renal mass nephron-sparing surgery

Robotic transperitoneal versus retroperitoneal approach for anterior renal mass nephron-sparing surgery

Risk of pseudoaneurysm and bleeding complications after partial nephrectomy: comparison of tumor enucleation to standard margin technique

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