Selective clamping under the usage of near-infrared fluorescence imaging with indocyanine green in robot-assisted partial nephrectomy: a single-surgeon matched-pair study

Abstract

Robot-assisted partial nephrectomy with selective clamping of the tumor feeding vascular branches is a promising technique for reduced ischemic renal trauma. This may lead to improved kidney function preservation.

Safety and Postoperative Outcomes of Regional versus Global Ischemia for Partial Nephrectomy: A Systematic Review and Meta-Analysis

“…Nohara et al [20] reported their results as mean change from baseline creatinine (mg/dl): global ischemia 0.15 versus regional ischemia 0.01, p = 0.012. Harke et al [17] reported their results as mean estimated glomerular filtration rate change from baseline (ml/min): global ischemia 16.1 versus regional ischemia 5.1, p = 0.045. Borofsky et al [18] also reported their results as mean estimated glomerular filtration rate change from baseline (%): global ischemia 14.9 versus regional ischemia 1.8, p = 0.03.…”

“…Six studies [8,17,18,19,20,21] reported margin status and one case [21] in global ischemia had a positive margin, while no cases in regional ischemia showed a positive margin (1 of 201 global ischemia cases vs. 0 of 162 regional ischemia cases).…”

“…Pooled data from six studies [8,17,18,19,20,21] which reported the operative time for PN showed that the operative times of regional and global ischemia were not significantly different (WMD = 20.35 min, 95% CI: -0.28-40.97, p = 0.05) (fig. 2a).…”

“…One casein the regional ischemia group underwent nephrectomy because of postoperative artery bleeding [17]. No open conversion was reported.…”

“…Pooled data from five studies [8,17,18,19,21] were used to assess complication and blood transfusion rates. Rates of complication of regional and global ischemia (OR = 1.16, 95% CI: 0.63-2.15, p = 0.63) (fig.…”