Trifecta Outcomes of Laparoscopic Partial Nephrectomy for T1a and T1b Renal Tumors: A Single-Center Experience in a Tertiary Care Institution

Demirdağ, Çetin; Çitgez, Sinharib; Gevher, Fatih; Şimşekoğlu, Muhammed Fatih; Yalçın, Veli

doi:10.1089/lap.2018.0756

Cited by 4 publications

(5 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Besides the definition of a diverse trifecta criterion, the characteristics of the patients and the tumor included in the studies, the surgical technique used and the surgical experience might have resulted in reporting disparate success rates (23,24). Therefore, the trifecta outcomes indicated in the literature vary from 32% to 81% (25). In the present study, since neither hilar nor segmental vessels were clamped in any case, all LPN procedures had warm ischemia time of zero.…”

Section: Discussionmentioning

confidence: 80%

Comparison of functional outcomes of off-clamp laparoscopic partial nephrectomy access techniques: A preliminary report

Mercimek

Özden

2021

Int. braz j urol.

View full text Add to dashboard Cite

Objective: This study aims to compare renal functional outcomes of access techniques in patients who underwent off-clamp (Off-C) laparoscopic partial nephrectomy (LPN). Materials and Methods: Thirty-four Off-C LPNs in patients with functioning contralateral kidney from March 2011 to June 2018 were included in the study. Twenty-two patients underwent transperitoneal, 12 patients underwent retroperitoneal Off-C LPN. The primary outcome was glomerular fi ltration rate changes over time, postoperatively. The secondary outcome was the evaluation of trifecta and pentafecta rate. Results: Preoperative demographics, tumor size (26.59 vs. 22.83mm, p=0.790), RENAL score (5.45 vs. 5.33, p=0.990), operation time (79.95 vs. 81.33 min, p=0.157), blood loss (170.23 vs. 150.83mL, p=0.790) were similar in both groups. Although preservation of renal function was better in group 2 in the early period, similar results were found in both groups at the end of the fi rst year, postoperatively. No positive surgical margin and postoperative major complications were detected in any patient. While trifecta goals were achieved in all the patients in the cohort, pentafecta rates were 90.9% and 91.7% in the transperitoneal and retroperitoneal groups, respectively. Conclusions: Transperitoneal and retroperitoneal access were found to have similar outcomes in terms of preservation of renal function at the end of the fi rst year postoperatively. Off-C LPN may be considered as a safe and effective treatment option in patients having non-complex renal tumors.

show abstract

Section: Discussionmentioning

confidence: 80%

Comparison of functional outcomes of off-clamp laparoscopic partial nephrectomy access techniques: A preliminary report

Mercimek

Özden

2021

Int. braz j urol.

View full text Add to dashboard Cite

show abstract

“…The objective of PN is to achieve a satisfactory oncological outcome and minimize complications while preserving (6)(7)(8)(9)(10). The only use of WIT≤25 min does not apply properly to demonstrate long term renal functional outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, there is no consensus on the definitions used for components of the Trifecta. The renal function preservation component of the Trifecta has been interpreted differently by the authors ( 6 – 10 ). The only use of WIT≤25 min does not apply properly to demonstrate long term renal functional outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…RENAL score failed to have such a link in the multivariate analysis. Cetindag et al Published a retrospective case series of laparoscopic PN with 128 patients, and reported that the tumor size was only a predictor of Trifecta ( 10 ). In a similar study including 63 patients undergoing laparoscopic PN in T1a renal masses, Osaka et al reported that the tumor size and surgeon’s learning curve were predictors of Trifecta outcomes ( 26 ).…”

Section: Discussionmentioning

confidence: 99%

“…In a study conducted by Sharma et al, Trifecta was defined as WIT <30 min ( 8 ). In several studies, the authors have applied strict Trifecta (negative surgical margin, no complications of grade 3 or higher, renal function loss <15%, and WIT≤25 min) to evaluate the renal function preservation more precisely ( 9 , 10 ).…”

Section: Introductıonmentioning

confidence: 99%

See 2 more Smart Citations

Predicting Strict Trifecta Outcomes after Robot-Assisted Partial Nephrectomy: Comparison of RENAL, PADUA, and C-Index Scores

Karamık

Aktaş

Erdemir

et al. 2021

jkcvhl

View full text Add to dashboard Cite

Nephrometry scores are designed to characterize tumors and stratify the surgical complexity. It remains unclear as to which nephrometry score can accurately predict the surgical outcomes. We aimed to assess the utility of radius, exophytic/endophytic, nearness, anterior/posterior, location (RENAL), preoperative aspects and dimensions used for anatomic classifications (PADUA), and centrality index (C-index) nephrometry scores for predicting the strict Trifecta achievement from a single institution series robotic-assisted partial nephrectomy (RAPN). We retrospectively identified the prospectively maintained robotic surgery database records of 91 patients who underwent RAPN between June 2015 and September 2020 in Antalya Training and Research Hospital. The main outcome of the study was the achievement of strict Trifecta (negative surgical margin, no major urologic complications, warm ischemia time ≤25 min, and ≥85% preservation of estimated glomerular filtration rate). A mul-tivariable analysis was performed to identify the factors of strict Trifecta success. The mean patient age was 55.82 ± 13.37 years with a median clinical tumor size of 3.5 cm (IQR 2.5–4.9). The median RENAL, PADUA, and C-index score were 7(IQR 6–8), 8(IQR 7–10), and 2.01(IQR 1.64–2.72), respectively. A strict Trifecta could be achieved in 54 patients (59.3%). Clinical tumor size (P = 0.011), RENAL risk groups (low:ref-erence; intermediate; P = 0.040; high; P = 0.009), PADUA risk groups (low:reference; intermediate; P = 0.044; high; P = 0.001) and C-index risk groups (low:reference; high; P = 0.015) were the independent predictors of strict Trifecta attainment in the multivariate analysis. None of the nephrometry scores were a superior predictor compared to other nephrometry scores in comparative analysis. RENAL, PADUA, and C-index scores were all independent predictors of a strict Trifecta achievement. Our comprehensive comparison of the three scores identified that none of the nephrometry scores proved to be inferior to others nephrometry scores.

show abstract

Retroperitoneal laparoscopic partial versus radical nephrectomy for large (≥ 4 cm) and anatomically complex renal tumors: A propensity score matching study

Deng

Zhou

Zhong

et al. 2020

European Journal of Surgical Oncology

View full text Add to dashboard Cite

Trifecta Outcomes of Laparoscopic Partial Nephrectomy for T1a and T1b Renal Tumors: A Single-Center Experience in a Tertiary Care Institution

Cited by 4 publications

References 40 publications

Comparison of functional outcomes of off-clamp laparoscopic partial nephrectomy access techniques: A preliminary report

Comparison of functional outcomes of off-clamp laparoscopic partial nephrectomy access techniques: A preliminary report

Predicting Strict Trifecta Outcomes after Robot-Assisted Partial Nephrectomy: Comparison of RENAL, PADUA, and C-Index Scores

Retroperitoneal laparoscopic partial versus radical nephrectomy for large (≥ 4 cm) and anatomically complex renal tumors: A propensity score matching study

Contact Info

Product

Resources

About