Predicting Complications After Robotic Partial Nephrectomy: Back to Simplicity

Khene, Z.; Mazouin, C.; Larcher, Alessandro; Peyronnet, B.; Gasmi, Anis; Roumiguié, M.; Verhoest, G.; Capitanio, Umberto; Mathiéu, Romain; Doumerc, N.; Montorsi, Francesco; Bensalah, Karim

doi:10.1016/j.euf.2021.04.017

Cited by 11 publications

(5 citation statements)

References 32 publications

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“…The NS system is also a predictor of long-term effect ( 16 ). Research on the predictive ability of the NS system has not weakened since the development of the scoring system ( 17 , 18 ). To improve the predictive ability of the scoring system, the new scoring system has been tried with many methods, including adding parameters ( 18 ), simplifying parameters, and modifying scoring through regression analysis ( 11 ).…”

Section: Discussionmentioning

confidence: 99%

Search for the optimized and key nephrometry elements combination in retroperitoneal laparoscopic partial nephrectomy: A retrospective study

Jin

Wang²,

Xing³

2023

Front. Surg.

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BackgroundThe nephrometry scoring system plays a key role in the preoperative evaluation of partial nephrectomy, and scoring systems based on anatomical characteristics have high similarity in scoring elements. Currently, there is little research on scoring systems related to retroperitoneal laparoscopic partial nephrectomy, and there is a lack of research on the combination of scoring elements, which requires further investigation.MethodsWe retrospectively analyzed the clinical records of 107 patients who underwent retroperitoneal laparoscopic partial nephrectomy conducted by a single operator at a single center. The score and scoring elements were generated based on imaging. The scoring elements of each scoring system and all combinations of two to five elements were extracted. The predictive ability of different score combinations was evaluated by AUC value, and the key parameters of the score were found by taking the intersection. A nomogram was constructed and evaluated.ResultsWe observed that with an increase in scoring elements, the strongest combination of elements did not significantly increase the predictive ability of warm ischemia time (P>0.05), postoperative complications (P>0.05), and trifecta achievement (P>0.05). The combination of the maximum tumor diameter and the distance between tumor and collecting system or renal sinus had a good comprehensive predictive ability, and there is no significant difference with the traditional score (P>0.05). The nomogram generated according to this combination has an excellent prediction ability for predicting whether obtain trifecta of partial nephrectomy.ConclusionsWithin the range of two to five elements, the critical degree of elements is more important than the number of elements. The maximum tumor diameter and the distance between the tumor and the collecting system or renal sinus was the key element of the prediction ability.

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Section: Discussionmentioning

confidence: 99%

Search for the optimized and key nephrometry elements combination in retroperitoneal laparoscopic partial nephrectomy: A retrospective study

Jin

Wang²,

Xing³

2023

Front. Surg.

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“…20 However, our and other studies demonstrated no increased risk based on RENAL score. 21 Complication rates are multifactorial and likely related to patient comorbidities, surgeon experience and volume, and/or improving renorrhaphy techniques. 22 Regarding WIT, it is possible that the additional WIT seen in the pASA cohort was due to more meticulous dissection in these patients due to concerns over bleeding risk.…”

Section: Discussionmentioning

confidence: 99%

Perioperative Aspirin Use Is Associated with Bleeding Complications during Robotic Partial Nephrectomy

et al. 2022

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Purpose: Daily aspirin use following cardiovascular intervention is commonplace and creates concern regarding bleeding risk in patients undergoing surgery. Despite its cardio-protective role, aspirin is often discontinued 5e7 days prior to major surgery due to bleeding concerns. Single institution studies have investigated perioperative outcomes of aspirin use in robotic partial nephrectomy (RPN). We sought to evaluate the outcomes of perioperative aspirin (pASA) use during RPN in a multicenter setting. Materials and Methods: We performed a retrospective evaluation of patients undergoing RPN at 5 high volume RPN institutions. We compared perioperative outcomes of patients taking pASA (81 mg) to those not on aspirin. We analyzed the association between pASA use and perioperative transfusion. Results: Of 1,565 patients undergoing RPN, 228 (14.5%) patients continued pASA and were older (62.8 vs 56.8 years, p <0.001) with higher Charlson scores (mean 3 vs 2, p <0.001). pASA was associated with increased perioperative blood transfusions (11% vs 4%, p <0.001) and major complications (10% vs 3%, p <0.001). On multivariable analysis, pASA was associated with increased transfusion risk (OR 1.94, 1.10e3.45, 95% CI). Conclusions: In experienced hands, perioperative aspirin 81 mg use during RPN is reasonable and safe; however, there is a higher risk of blood transfusions and major complications. Future studies are needed to clarify the role of antiplatelet therapy in RPN patients requiring pASA for primary or secondary prevention of cardiovascular events.

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“…Puis est apparu le concept de complexité tumorale avec la publication de scores morphométriques prenant en compte plusieurs paramètres (taille de la tumeur, caractère endoou exophytique, proximité avec le hile, position centrale ou polaire). Les plus connus sont le RENAL score, le PADUA score et le score ABC [18].…”

Section: La Taille Et La Complexité De La Tumeurunclassified

“…Tous les scores sont basés sur l'imagerie préopératoire et ont été calculés à partir de bases de données historiques. Leur capacité à prédire les complications est débattue : certaines études ont suggéré qu'ils étaient de bons prédicteurs de la morbidité postopératoire mais cette association n'a pas été retrouvée par d'autres [18].…”

Section: La Taille Et La Complexité De La Tumeurunclassified

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Les complications de la néphrectomie totale et de la néphrectomie partielle : quelles sont-elles, comment les prévenir et les prendre en charge ?

Bensalah

Pignot

Legeais³

et al. 2022

Progrès en Urologie

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Predicting Complications After Robotic Partial Nephrectomy: Back to Simplicity

Cited by 11 publications

References 32 publications

Search for the optimized and key nephrometry elements combination in retroperitoneal laparoscopic partial nephrectomy: A retrospective study

Search for the optimized and key nephrometry elements combination in retroperitoneal laparoscopic partial nephrectomy: A retrospective study

Perioperative Aspirin Use Is Associated with Bleeding Complications during Robotic Partial Nephrectomy

Les complications de la néphrectomie totale et de la néphrectomie partielle : quelles sont-elles, comment les prévenir et les prendre en charge ?

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