Modified laparoscopic simple enucleation with single-layer suture technique versus standard laparoscopic partial nephrectomy for treating localized renal cell carcinoma

Lü, Qun; Zhao, Xiaozhi; Ji, Changwei; Guo, Suhan; Liu, Guangxiang; Zhang, Shiwei; Li, Xiaogong; Gan, Weidong; Guo, Hongqian

doi:10.1007/s11255-016-1470-1

Cited by 19 publications

(38 citation statements)

References 29 publications

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“…In the study, mean operative time and warm ischemia time were 104.3±18.2 min and 21.3±3.5 min, respectively. The results are comparable to previous studies ( 11 , 12 ). SE is possible because most localized renal masses are enveloped by a peritumoral pseudocapsule containing muscle, reticulin and collagens ( 6 ).…”

Section: Discussionsupporting

confidence: 91%

“…NSS includes sharp excision, namely partial nephrectomy (PN) and blunt dissection, namely simple enucleation (SE). Given the advantages that SE had comparable oncological outcomes with PN and less complications than PN, SE was recommended to treat localized renal tumors ( 9 – 12 ). Even for some highly complex renal tumors, Serni S, et al ( 8 ) reported that SE was an effective treatment with a potential key role to widen the NSS indications according to guidelines.…”

Section: Discussionmentioning

confidence: 99%

“…Perhaps because the renal sinus was less frequently entered and tumor bed suturing was less frequently needed, WIT was saved in SE group. Furthermore, SE can be conducted without hilar clamping more often than PN ( 12 ). In the study, mean operative time and warm ischemia time were 104.3±18.2 min and 21.3±3.5 min, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Nowadays, SE is routinely performed for familial RCC and sporadic RCC, which can retain the maximum normal parenchyma in order to reduce the risk of chronic kidney disease development ( 7 , 8 ). Recently, it has been reported that tumor SE had revealed comparable oncologic outcomes compared with standard margin partial nephrectomy for RCC ( 9 – 12 ). However, it is understood that, most of the previous articles were about SE in the treatment of clear cell RCCs.…”

Section: Introductionmentioning

confidence: 99%

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Localized chromophobe renal cell carcinoma: preoperative imaging judgment and laparoscopic simple enucleation for treatment

Ren

Xue

et al. 2018

Int. braz j urol.

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Objective:To evaluate the preoperative imaging manifestation and therapeutic effect of laparoscopic simple enucleation (SE) for localized chromophobe renal cell carcinoma (chRCC).Materials and Methods:Clinical data of 36 patients who underwent laparoscopic SE of localized chRCC at our institute were retrospectively analyzed. All patients underwent preoperative renal protocol CT (unenhanced, arterial, venous, and delayed images). CT scan characteristics were evaluated. After intraoperative occlusion of the renal artery, the tumor was free bluntly along the pseudocapsule and enucleated totally. The patients were followed up regularly after the operation.Results:Mean tumor diameter was 3.9±1.0 cm, 80% of tumors were homogeneous and all the tumors had complete pseudocapsule. The attenuation values were slightly lower than normal renal cortex and degree of enhancement of the tumors were significantly lower than normal renal cortex. Mean operation time was 104.3±18.2 min. Mean warm ischemia time (WIT) was 21.3±3.5 min. Mean blood loss was 78.6±25.4 mL. No positive surgical margin was identified. Mean postoperative hospital stay was 5.3±1.5 d. Hematuria occurred in 3 patients and all disappeared within 3 days. After a mean follow-up of 32.1±20.6 months, no patient had local recurrence or metastatic progression.Conclusion:Localized chRCCs have a great propensity for homogeneity and complete pseudocapsule. The attenuation values were slightly lower than normal renal cortex and small degree of enhancement. Laparoscopic SE is a safe and effective treatment for localized chRCC. The oncological results were satisfactory.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Localized chromophobe renal cell carcinoma: preoperative imaging judgment and laparoscopic simple enucleation for treatment

Ren

Xue

et al. 2018

Int. braz j urol.

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“…Interestingly, Lu et al. compared 280 simple enucleations using a single‐layer technique with105 standard LPNs using a double‐layer suture. Even with more lesions with a PADUA score >10, (22.2% vs 11.4%; P = 0.017), the simple enucleation group achieved lower WIT and a lower complication rate, with similar oncological outcomes.…”

Section: Resultsmentioning

confidence: 99%

Suture techniques during laparoscopic and robot‐assisted partial nephrectomy: a systematic review and quantitative synthesis of peri‐operative outcomes

et al. 2018

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Robotic‐assisted laparoscopic tumor enucleation is a feasible technique for renal hilar tumors: A retrospective study

Liu

Zhao

Feng

et al. 2021

Journal of Surgical Oncology

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Background and Objective This study aimed to evaluate the safety and efficacy of robot‐assisted laparoscopic tumor enucleation (RAE) for the treatment of renal hilar tumors and to describe our experience with renorrhaphy‐related surgical techniques. Methods Retrospective data were collected from 173 consecutive patients who underwent RAE for localized renal tumors (cT1–cT2N0M0) at our hospital between September 2014 and November 2019. Results Seventy‐five patients had renal hilar tumors and 98 patients had nonhilar tumors. There were no statistical differences between the hilar and nonhilar groups in operation time (190 [115–390] vs. 190 [110–390] min, p = 0.889), warm ischemia time (26 [12–60] vs. 27 [17–41] min, p = 0.257), hospital stay duration (8 [3–16] vs. 7.5 [4–18] days, p = 0.386), renal function (estimated glomerular filtration rate, 102.5 [29.4–144] vs. 101.3 [64.2–134.7] ml/min/1.73 m2, p = 0.631); creatinine level, (76 [43–169] vs. 78.5 [50–281.3] µmol/L, p = 0.673), perioperative complications rate, or surgical margin status. However, patients with hilar tumors lost significantly more blood than did those with nonhilar tumors (250 [50–1500] vs. 200 [20–1200] ml, p = 0.007). During the follow‐up period (median, 30 months), three patients in each group experienced recurrence. The 5‐year recurrence‐free rates were 93.0% and 95.4% in the hilar and nonhilar tumor groups, respectively (p = 0.640). Conclusions For experienced robot laparoscopists, RAE is a safe, effective, and feasible procedure for renal hilar tumors, without increased risk of positive surgical margins or worse midterm oncologic outcomes compared with nonhilar tumors.

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Modified laparoscopic simple enucleation with single-layer suture technique versus standard laparoscopic partial nephrectomy for treating localized renal cell carcinoma

Abstract: MLSE may confer shorter warm ischemic time, almost no need for tumor bed suturing and less grade III complications than SLPN, with similar oncologic outcomes. MLSE may be safe and acceptable for patients undergoing partial nephrectomy.

Cited by 19 publications

References 29 publications

Localized chromophobe renal cell carcinoma: preoperative imaging judgment and laparoscopic simple enucleation for treatment

Localized chromophobe renal cell carcinoma: preoperative imaging judgment and laparoscopic simple enucleation for treatment

Suture techniques during laparoscopic and robot‐assisted partial nephrectomy: a systematic review and quantitative synthesis of peri‐operative outcomes

Robotic‐assisted laparoscopic tumor enucleation is a feasible technique for renal hilar tumors: A retrospective study

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