Robotic partial nephrectomy for clinical stage T1 tumors: Experience in 42 cases

Ener, Kemal; Canda, Abdullah Erdem; Altinova, Serkan; Atmaca, Ali Fuat; Alkan, Erdal; Asil, Erem; Ozcan, Muhammet Fuat; Akbulut, Ziya; Balbay, Mevlana Derya

doi:10.1016/j.kjms.2015.09.008

Cited by 6 publications

(3 citation statements)

References 31 publications

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“…The map scoring system was proposed in [ 3 ]. The MAP scoring system is a more comprehensive quantitative scoring method for assessing the anatomical complexity of renal tumours, which corresponds to the anatomical features of renal tumours with capital initials [ 4 ]. The variables are simple to set and relatively easy to measure [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

U-Net Modelling-Based Imaging MAP Score for Tl Stage Nephrectomy: An Exploratory Study

Sun

Chang

et al. 2022

Journal of Healthcare Engineering

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We evaluate the stability of the clinical application of the MAP scoring system based on anatomical features of renal tumour images, explore the relevance of this scoring system to the choice of surgical procedure for patients with limited renal tumours, and investigate the effectiveness of automated segmentation and reconstruction 3D models of renal tumour images based on U-net for interpretative cognitive navigation during laparoscopy Tl stage radical renal tumour cancer surgery. A total of 5 000 kidney tumour images containing manual annotations were applied to the training set, and a stable and efficient full CNN algorithm model oriented to clinical needs was constructed to regionalism and multistructure and to finely automate segmentation of kidney tumour images, output modelling information in STL format, and apply a tablet computer to intraoperatively display the Tl stage kidney tumour model for cognitive navigation. Based on a training sample of MR images from 201 patients with stage Tl renal tumour cancer, an adaptation of the classical U-net allows individual segmentation of important structures such as renal tumours and 3D visualisation to visualise the structural relationships and the extent of tumour invasion at key surgical sites. The preoperative CT and clinical data of 225 patients with limited renal tumours treated surgically at our hospital from August 2011 to August 2012 were retrospectively analysed by three imaging physicians using the MAP scoring system for the total score and the variables R (maximum diameter), E (exogenous/endogenous), N (distance from the renal sinus), A (ventral/dorsal), L (relationship along the longitudinal axis of the kidney), and h (whether in contact with the renal hilum). The score for each variable (contact with the renal hilum) was statistically compared with each other for the three observers. Patients were divided into three groups according to the total score—low, medium, and high—and according to the surgical procedure—radical and partial resection. The correlation between the total score and the score of each variable and the choice of surgical procedure was analysed. The agreement rate of the total score and the score of each variable for all three observers was over 90% ( P ≤ 0.001). The map scoring system based on the anatomical features of renal tumour imaging was well stabilized, and the scores were significantly correlated with the surgical approach.

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Section: Introductionmentioning

confidence: 99%

U-Net Modelling-Based Imaging MAP Score for Tl Stage Nephrectomy: An Exploratory Study

Sun

Chang

et al. 2022

Journal of Healthcare Engineering

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“…Today, partial nephrectomy (PN) is preferred in kidney masses <4 cm, and in tumors between 4–7 cm, if suitable [ 2 ]. Previously, it has been reported that PN had similar oncologic outcomes with favorable functional outcomes compared with radical nephrectomy (RN) [ 3 ]. During robotic and laparoscopic procedures, the failure of kidney cooling is still remaining as a challenging point [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Zero ischemia robotic partial nephrectomy: Oncological and functional outcomes of a multicenter study

ENER,

CANDA,

BİNBAY

et al. 2023

Turkish Journal of Medical Sciences

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Background/aim The functional and oncological outcomes of zero ischemia robotic partial nephrectomy (RPN) procedures were evaluated. Materials and methods A total of 56 patients underwent zero ischemia RPN transperitoneally, and their data were collected prospectively. Radius, exo/endophytic, nearness, anterior/posterior, location (R.E.N.A.L.) nephrometry, and PADUA scores were calculated. Patient and tumor characteristics were evaluated. Intra- and perioperative (0–30 days) complications were evaluated by Clavien classification. The change in serum creatinine, and estimated glomerular filtration rates (eGFR) were evaluated during preoperative, immediate postoperative periods, and at postoperative 6 th months. Results The mean age of the patients was 52.2 ± 8.1 (27–75) years. R.E.N.A.L. nephrometry and PADUA scores were 6.1 ± 1.3 and 7.3 ± 1.0, respectively. The duration of surgery was 108.4 ± 18.2 min and estimated blood loss was 166.2 ± 124.7 mL. There were no intraoperative complications in any of the patients. Clavien Grade 1 and 3 complications were seen in 2 patients in the perioperative period. In the perioperative period (1–30 days), one patient required blood transfusion and angiographic intervention due to postoperative bleeding (Clavien Grade 3), and one patient required hospitalisation due to prolonged subileus (Clavien Grade 1) that resolved conservatively. The radiological and pathological tumor sizes were 3.1 ± 1.1 cm and 2.8 ± 1.4 cm, respectively. The surgical margins were positive in two patients with tumour sizes of 1.5 and 4 cm. Neither local recurrence nor distant metastasis was detected, during 33.6 ± 12.3 (3–76) months. There were no statistically significant differences between preoperative eGFR and serum creatinine levels, compared with those of immediate postoperative and postoperative 6 th month periods. Conclusion Zero ischemia RPN is a safe and applicable method with acceptable oncological and functional outcomes in small renal tumors and even in selected larger renal tumors.

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“…After the introduction of the da Vinci robotic system (Intuitive Surgical, Sunnyvale, CA, USA), several reports showing the feasibility and safety of the procedure have been reported. [4][5][6][7][8][9][10] The utilization of the robot in this field has facilitated the PN procedure, especially during the periods of renal parenchymal dissection, renorhaphy and warm ischemia after the excision of the tumor. [11] In this study, we present our experience with robotic partial nephrectomy (RPN) in 34 patients with (n=22) and without (n=12) renal arterial clamping, and evaluate the impact of these techniques on renal functions by analyzing estimated glomerular filtration rates (eGFRs).…”

Section: Introductionmentioning

confidence: 99%

Impact of robotic partial nephrectomy with and without ischemia on renal functions: experience in 34 cases

Ener

Canda

Altinova

et al. 2016

Turkish Journal of Urology

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Objective: In this study we aimed to compare renal functions in patients who underwent robotic partial nephrectomy (RPN) with on-clamp and zero-ischemia techniques. Material and methods:Between 2009 and 2015, 12 off-clamp and 22 on-clamp RPN procedures were performed on a total of 34 patients in two centers. The main outcome parameters examined were serum creatinine, and estimated glomerular filtration rate (eGFR) during preoperative, immediate postoperative periods, and at postoperative 3 rd months.Results: There were no statistically significant differences between on-clamp and zero-ischemia groups regarding age, ASA score, BMI, PADUA and R.E.N.A.L. nephrometry scores, operation time and tumor size (p>0.05). Significant differences were found in the duration of hospital stay (3.8±0.9 days vs. 3.0±0.9 days) and amount of blood loss (85.9±49.6 mL vs. 183.3±176.2 mL) between the on-clamp and zero-ischemia groups (p<0.05). Statistically significant differences were found between preoperative and immediate postoperative periods, in terms of eGFR and serum creatinine levels in both groups. Moreover, statistically significant differences were found between preoperative and postoperative 3 rd month periods, in the on-clamp group in terms of eGFR and serum creatinine levels. In the zero-ischemia group, the decrease in eGFR and serum creatinine levels at postoperative 3 rd month relative to the preoperative period was not statistically significant. Conclusion:Off-clamp RPN technique is superior, in short-term outcomes involving renal functions, compared to on clamp approach. However, long-term data regarding the renal functions should be evaluated to arrive at a definitive decision.

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Robotic partial nephrectomy for clinical stage T1 tumors: Experience in 42 cases

Cited by 6 publications

References 31 publications

U-Net Modelling-Based Imaging MAP Score for Tl Stage Nephrectomy: An Exploratory Study

U-Net Modelling-Based Imaging MAP Score for Tl Stage Nephrectomy: An Exploratory Study

Zero ischemia robotic partial nephrectomy: Oncological and functional outcomes of a multicenter study

Impact of robotic partial nephrectomy with and without ischemia on renal functions: experience in 34 cases

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