Resection Techniques During Robotic Partial Nephrectomy: A Systematic Review

Bertolo, Riccardo; Pecoraro, Alessio; Carbonara, Umberto; Diana, Pietro; Muselaers, Stijn; Marchioni, M.; Mir, Maria Carmen; Antonelli, Alessandro; Badani, Ketan K.; Breda, Alberto; Challacombe, B.; Kaouk, Jihad; Mottrie, Alexandre; Porpiglia, Francesco; Porter, J.; Minervini, Andrea; Campi, Riccardo

doi:10.1016/j.euros.2023.03.008

Cited by 31 publications

(3 citation statements)

References 51 publications

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“…The second key finding of our study is that surgical resection strategy and, in result, the resection technique employed, may significantly vary in locally recurrent RCCs, mainly on the basis of several baseline tumor-related features [27] . In this context, by harnessing the SIB score to report resection techniques performed in a standardized fashion, the current manuscript can contribute to the ongoing debate and overcomes the limits of previous studies, ultimately providing novel findings that may help better contextualize the current robotic redo PN literature.…”

Section: Discussionmentioning

confidence: 91%

Redo Partial Nephrectomy for Local Recurrence After Previous Nephron-sparing Surgery. Surgical Insights and Oncologic Results from a High-volume Robotic Center

Di Maida,

Grosso,

Campi

et al. 2023

European Urology Open Science

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Section: Discussionmentioning

confidence: 91%

Redo Partial Nephrectomy for Local Recurrence After Previous Nephron-sparing Surgery. Surgical Insights and Oncologic Results from a High-volume Robotic Center

Di Maida,

Grosso,

Campi

et al. 2023

European Urology Open Science

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“…The margins of the tumor were marked using monopolar cautery (Figure 1 ). Subsequently, the renal artery was clamped (the renal vein was not clamped to ensure retrograde perfusion), and the tumor was resected with sufficient margins in the enucleative resection plane, with the utmost care taken to preserve the surrounding healthy parenchyma while ensuring adequate tumor margins (Figure 2 ) [ 7 ]. The steps of this technique in both open and robotic approaches were identical.…”

Section: Methodsmentioning

confidence: 99%

A Novel Technique of Renorrhaphy in Difficult Partial Nephrectomies by Single-Layered Parenchymal Imbrication

Raghavan,

Kannan,

Sekaran

et al. 2023

Cureus

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Background In partial nephrectomies, achieving the trifecta outcome of negative tumor margins, no surgical complications, and minimal decline in renal function depends on various factors, with the complexity of the tumor described by the nephrometry score being chief among them. These factors often motivate surgeons toward a minimally invasive route even if the preferred route is an open approach. We describe an innovative renorrhaphy technique that overcomes the commonly encountered difficulty in reconstructing the renal parenchyma after resecting a complex tumor with a single-layered parenchymal imbrication (SLPI) technique. Methodology We conducted a retrospective review of case records of the patients who had undergone partial nephrectomies in our center from March 2017 to March 2021. The patients who underwent the SLPI technique were chosen, and data were extracted. Data collected included patients' preoperative imaging findings; intraoperative parameters such as ischemia time, blood loss, and number of renal arteries; and postoperative factors such as margin positivity rate, urine leak, secondary bleeding, follow-up imaging, and recurrence rates. Results A total of 28 patients were included in our study. The estimated blood loss was 234 mL (standard deviation [SD] = 55 mL), warm ischemia time was 31 minutes (SD 4 minutes), a hospital stay of 3 days (SD 2 days), two minor complications, two intraoperative complications, and one margin positivity. There were no major complications or recurrences. Conclusions The novel technique of SLPI renorrhaphy can help deal with complex renal masses and is an easily reproducible technique both in open and minimally invasive approaches.

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“…However, examining and analyzing the complex histological patterns of RCC surgical resection specimens under a microscope can be challenging and time consuming for pathologists for many reasons. For instance, nephrectomy specimens exhibit substantial heterogeneity, exemplifying the wide variation observed within RCC surgical resection samples [ 65 ]. Moreover, variability among different observers, and even within the same observer, has been reported [ 33 ].…”

Section: Artificial Intelligence Aided Diagnosis Of Rcc Subtypesmentioning

confidence: 99%

Artificial Intelligence in Renal Cell Carcinoma Histopathology: Current Applications and Future Perspectives

Distante,

Marandino,

Bertolo

et al. 2023

Diagnostics

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Renal cell carcinoma (RCC) is characterized by its diverse histopathological features, which pose possible challenges to accurate diagnosis and prognosis. A comprehensive literature review was conducted to explore recent advancements in the field of artificial intelligence (AI) in RCC pathology. The aim of this paper is to assess whether these advancements hold promise in improving the precision, efficiency, and objectivity of histopathological analysis for RCC, while also reducing costs and interobserver variability and potentially alleviating the labor and time burden experienced by pathologists. The reviewed AI-powered approaches demonstrate effective identification and classification abilities regarding several histopathological features associated with RCC, facilitating accurate diagnosis, grading, and prognosis prediction and enabling precise and reliable assessments. Nevertheless, implementing AI in renal cell carcinoma generates challenges concerning standardization, generalizability, benchmarking performance, and integration of data into clinical workflows. Developing methodologies that enable pathologists to interpret AI decisions accurately is imperative. Moreover, establishing more robust and standardized validation workflows is crucial to instill confidence in AI-powered systems’ outcomes. These efforts are vital for advancing current state-of-the-art practices and enhancing patient care in the future.

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Resection Techniques During Robotic Partial Nephrectomy: A Systematic Review

Cited by 31 publications

References 51 publications

Redo Partial Nephrectomy for Local Recurrence After Previous Nephron-sparing Surgery. Surgical Insights and Oncologic Results from a High-volume Robotic Center

Redo Partial Nephrectomy for Local Recurrence After Previous Nephron-sparing Surgery. Surgical Insights and Oncologic Results from a High-volume Robotic Center

A Novel Technique of Renorrhaphy in Difficult Partial Nephrectomies by Single-Layered Parenchymal Imbrication

Artificial Intelligence in Renal Cell Carcinoma Histopathology: Current Applications and Future Perspectives

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