Long‐term outcome of hand‐assisted laparoscopic radical nephrectomy for <scp>T</scp>1 renal cell carcinoma

Hongo, Fumiya; Kawauchi, Akihiro; Ueda, Takashi; Fujihara, Atsuko; Naitoh, Yasuyuki; Nakamura, Toshio; Naya, Yoshio; Kamoi, Kazumi; Okihara, Koji; Miki, Tsuneharu

doi:10.1111/iju.12551

Cited by 5 publications

(4 citation statements)

References 26 publications

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“…For kidney extraction it benefits a larger incision, but disposable hand-port devices increases the cost of the procedure. HALRN might be comparable with open nephrectomy with regard to long-term cancer control [35]. Patients with larger renal mass like shown in Figure 3, (12x10 cm ; covering all the renal parenchym suggesting T3a), can be operated by HALRN.…”

Section: Hand-assisted Laparoscopic Radical Nephrectomy(halrn)mentioning

confidence: 98%

Minimal Invasive Treatments for Renal Cell Carcinoma

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Sungur

2020

ann urol oncol

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Renal cell carcinoma (RCC) is the most common malignancy of the kidney that accounts 85% of all renal tumors and 2-3% of all adult malignancies . The etiology of RCC associated with smoking , obesity, anti-hypertensive therapy, coffee and tea, Western diet (high fat and protein and low fruits and vegetables). However, the detection of small renal masses has been increased because of widespread use of sonography, computed tomography and magnetic resonance imaging techniques in recent years, but one-third of the patients with RCC still present with large, locally advanced or metastatic disease. Surgery is the main treatment for renal cell carcinoma and minimal invasive treatments such as laproscopy and robotic approaches is very popular in the world after the widespread use of technological instruments and technology.

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Section: Hand-assisted Laparoscopic Radical Nephrectomy(halrn)mentioning

confidence: 98%

Minimal Invasive Treatments for Renal Cell Carcinoma

Çalışkan

Sungur

2020

ann urol oncol

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“…In this issue of the journal, Hongo et al . retrospectively evaluated the long‐term outcomes of hand‐assisted laparoscopic radical nephrectomy (HALS‐Nx) versus open nephrectomy (OPEN‐Nx) in patients with T1 renal cell carcinoma (RCC) . The median duration of the follow up was 65 and 84 months in the HALS‐Nx and OPEN‐Nx groups, respectively.…”

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confidence: 99%

Editorial Comment from Dr Golebiewski to Long‐term outcome of hand‐assisted laparoscopic radical nephrectomy for T1 renal cell carcinoma

Gołębiewski

2014

Int J of Urology

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The median duration of the follow up was 65 and 84 months in the HALS-Nx and OPEN-Nx groups, respectively. Regarding the surgical outcomes, the operation times and complication rates showed no significant difference between the two groups. However, the blood loss was significantly lower in the HALS-Nx group. During the follow-up period, no significant differences were noted in either the 7-and 10-year recurrencefree rates or the cancer-specific 7-and 10-year survival rates between the two groups. The authors conclude that the longterm safety and curability of HALS-Nx is comparable with that of OPEN-Nx. The hand-assisted laparoscopic surgical technique has not compromised oncological outcomes in the RCC patients. Furthermore, the complication rates have been shown to be comparable with the open technique. Their findings were in agreement with those of other reports. 2,3The limitations of the present study included its retrospective nature and selection bias. A prospective, randomized trial of HALS-Nx and OPEN-Nx should be considered as a more objective and informative assessment of the outcomes of those surgical techniques in RCC patients.Laparoscopic radical nephrectomy (LRN) has become a standard treatment modality for patients with localized RCC. In long-term follow up, LRN has shown excellent oncological outcome, equal to open surgery for both stage T1 and T2 renal tumors.3,4 However, no consensus has yet been established regarding the best laparoscopic access for LRN. Each technique offers advantages and disadvantages. Hand-assisted LRN offers morbidity and recovery that are comparable with those of standard laparoscopy. The benefits of hand-assisted LRN include shorter learning curve, direct manual control of operative field, easier intact specimen removal and shorter operative time. In the analysis presented by Silberstein, handassisted nephrectomy was associated with significantly less operative blood loss and risk of open conversion than was pure laparoscopic nephrectomy. 5 The data presented support the role of hand-assisted laparoscopic nephrectomy as one of the treatment options for renal cancer when nephron-sparing surgery is not suitable. To assess the true oncological efficacy of the procedure, a longer follow-up period (>10 years) is necessary. Based on the current knowledge, one could anticipate the same excellent results of hand-assisted LRN that have been shown in conventional radical laparoscopic nephrectomy.Surgeons' experience and personal preference remain the most important factors that guide their choice of laparoscopic technique, but it has to be acknowledged that the treatment for the patient with localized RCC needs to be highly individualized. Therefore, it is crucial for surgeons to access unbiased information regarding the outcome of different laparoscopic techniques to help them make the choice that best suits the individual patient.

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“…Hongo et al used an assistant's hand for hand assistance instead of an operator's hand. 2 The use of the assistant's hand is a different method from other reported procedures. 1,3 Using the assistant's hand, the operator can freely use both hands for handling forceps or scissors, which is similar to SLS-RNx, and carry out fine dissection.…”

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confidence: 99%

“…Hongo et al . used an assistant's hand for hand assistance instead of an operator's hand . The use of the assistant's hand is a different method from other reported procedures .…”

mentioning

confidence: 99%