‘Trifecta’ outcomes of robot-assisted partial nephrectomy: a large Japanese multicenter study

Furukawa, Junya; Kanayama, Hiro‐omi; Azuma, Haruhito; Inoue, Keiji; Kobayashi, Yasuyuki; Kashiwagi, Akira; Segawa, Tomio; Takahashi, Yūzō; Horie, Shigeo; Ogawa, Osamu; Takenaka, Atsushi; Shiroki, Ryoichi; Tanabe, Kazunari; Fujisawa, Masato

doi:10.1007/s10147-019-01565-0

Cited by 24 publications

(21 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Similarly, Furukawa et al in a Japanese multicenter cohort of RAPN found that tumor size and hilar location, but not RENAL score, were predictors of trifecta achievement. 21 In the present high-complexity cohort, PADUA score was also not predictive for operative time, EBL, WIT, length of hospital stay and major complications. The present findings support the theory that as tumor diameter increases, the fewer additional variables are required to predict perioperative outcomes.…”

Section: Discussionmentioning

confidence: 46%

Robot‐assisted partial nephrectomy for high‐complexity tumors (PADUA score ≥10): Perioperative, long‐term functional and oncologic outcomes

et al. 2021

View full text Add to dashboard Cite

To evaluate the safety and efficacy, and long-term functional and oncologic outcomes of robot-assisted partial nephrectomy in high-complexity tumors. Methods: Data of 155 patients with a high-complexity tumor (PADUA score ≥10) were reviewed. Trifecta achievement, intra-, perioperative, functional, and oncologic outcomes were analyzed and compared between patients with increasing complexity. Results: Of the 155 patients, 65 (41.9%) patients had a PADUA score of 10, 55 (35.5%) had a PADUA score of 11, and 35 (22.6%) had a PADUA score of 12-13, respectively. The median (interquartile range) operative time, warm ischemia time and estimated blood loss were 150 min (112-186 min), 26 min (23-32 min) and 250 mL (100-500 mL), respectively. Postoperatively, complications occurred in 25 (16.1%) patients, and positive surgical margins in 15 (10.5%) patients. Trifecta was achieved in 67 (43.2%) patients. At a median follow-up period of 58 months, the median estimated glomerular filtration rate preservation was 87% (78-110), and 12 (7.7%) patients developed new-onset chronic kidney disease. Recurrence-free survival and overall survival rates were 93.6% and 96.7%, respectively. Positive surgical margins were statistically different between the groups of PADUA score 10, 11 and 12-13 (P = 0.017), whereas functional and oncologic outcomes were similar. In multivariate logistic regression analysis, increasing tumor size (odds ratio 1.48, 95% confidence interval 1.21-1.87; P < 0.001) and the American Society of Anesthesiologists score 2/3 (odds ratio 0.48, 95% confidence interval 0.24-0.96; P = 0.041) were independent predictors of trifecta failure. Conclusions: Robot-assisted partial nephrectomy is a safe and effective treatment for high-complexity tumors providing excellent long-term functional and oncologic outcomes.

show abstract

Section: Discussionmentioning

confidence: 46%

Robot‐assisted partial nephrectomy for high‐complexity tumors (PADUA score ≥10): Perioperative, long‐term functional and oncologic outcomes

et al. 2021

View full text Add to dashboard Cite

show abstract

“…16,17 We started to apply RP-RPN in our centre after we carried-out The most important expectation in ideal PN is the absence of perioperative complication, surgical margin negativity, and minimal impairment of renal function, defined as the term of "Trifecta ". 19,20 WIT is the leading factor that affecting the renal functions after PN.…”

Section: Discussionmentioning

confidence: 99%

Retroperitoneal robot‐assisted laparoscopic partial nephrectomy for posterior located renal tumours: Technique and early term outcomes

Boğa

Ateş

2020

Int J Clin Pract

View full text Add to dashboard Cite

Radical nephrectomy (RN) procedure decreased in small renal masses over time and conversely, partial nephrectomy (PN) increased, because of its contribution to renal functions and consequently its positive effect on chronic kidney disease (CKD) and survival. 1,2 Minimally invasive methods such as robot-assisted partial nephrectomy (RPN) and laparoscopic partial nephrectomy (LPN) provide advantages such as less postoperative pain, short hospital stay, and better quality of life after the surgery, similar oncological and functional results with open

show abstract

“…В современных руководствах рекомендовано выполнять резекцию опухолей почек во всех случаях, когда это возможно [3,4]. В последние десятилетия произошло смещение приоритета в сторону использования малоинвазивных методик (лапароскопических и робот-ассистированных) в хирургии рака почки, в том числе при выполнении органосохраняющих операций [5,6]. Эти виды хирургического лечения демонстрируют отличные интра-и послеоперационные результаты (малый объем кровопотери, короткий период госпитализации и реабилитации), хотя считаются более сложными и требуют специализированных навыков хирурга [1,2].…”

Section: Introductionunclassified

Complications of robot-assisted and laparoscopic partial nephrectomy

Rakul¹,

Поздняков²,

Елоев³

2021

Onkourologiâ

View full text Add to dashboard Cite

Objective: to analyze complications after laparoscopic and robotic-assisted partial nephrectomy.Materials and methods. In our study was included 246 cases. Intra- and postoperative complications were studied after nephron-sparring surgery. The laparoscopic approach was used in 68 (27.3 %) cases, the robot-assisted - in 178 (71.5 %) cases. Intraoperative complications were assessed according to the Rosenthal classification, postoperative complications - according to the Clavien-Dindo classification.Results. The overall incidence of intraoperative complications was 12.6 %. The most frequent intraoperative complication was bleeding that did not require blood transfusion (grade I) - 5.69 % (laparoscopic approach - in 3 (4.41 %) cases, robot-assisted approach - in 11 (6,18 %) cases). Bleeding requiring blood transfusion and injuries of internal organs, which were restored intraoperatively (grade II), were recorded in laparoscopic and robot-assisted approaches in 4.41 % and 2.25 % of cases, respectively. Complications leading to the loss of organ (nephrectomy, splenectomy) were observed in 2.94 % and 4.49 % of cases, respectively. Intraoperative deaths (grade IV) were not registered.The incidence of postoperative complications was 18.29 %. Minor complications (Clavien-Dindo ≤II) were detected in 16 (6.5 %) patients (laparoscopic approach - 7.35 %, robot-assisted approach - 6.18 %). Serious complications (Clavien-Dindo ≥III) were detected in 29 (11.79 %) cases (with laparoscopic approach - 14.71 %, robot-assisted - 10.67 %). In the group of tumors with the RENAL index 4-6, the incidence of postoperative complications was 14.7 % with the laparoscopic approach, and 7.1 % with the robot-assisted approach; in the RENAL 7-9 group - 21.9 % and 13.0 %, respectively. In the group of tumors of high complexity (RENAL 10-12), only the robot-assisted approach was used, the incidence of postoperative complications was 22.0 %.Conclusion. Partial nephrectomy for kidney tumors is an effective and safe surgical technique. The incidence of complications when using the laparoscopic approach is higher than when using the robot-assisted technique in groups of tumors of simple and medium complexity. For tumors of high complexity, robot-assisted approach is a priority. The largest number of serious complications is observed with partial nephrectomy with complex tumors.

show abstract

‘Trifecta’ outcomes of robot-assisted partial nephrectomy: a large Japanese multicenter study

Cited by 24 publications

References 27 publications

Robot‐assisted partial nephrectomy for high‐complexity tumors (PADUA score ≥10): Perioperative, long‐term functional and oncologic outcomes

Robot‐assisted partial nephrectomy for high‐complexity tumors (PADUA score ≥10): Perioperative, long‐term functional and oncologic outcomes

Retroperitoneal robot‐assisted laparoscopic partial nephrectomy for posterior located renal tumours: Technique and early term outcomes

Complications of robot-assisted and laparoscopic partial nephrectomy

Contact Info

Product

Resources

About