Purely off-clamp robotic partial nephrectomy: Preliminary 3-year oncological and functional outcomes.

Autor: Simone G; Department of Urology, 'Regina Elena' National Cancer Institute, Rome, Italy., Misuraca L; Department of Urology, 'Regina Elena' National Cancer Institute, Rome, Italy., Tuderti G; Department of Urology, 'Regina Elena' National Cancer Institute, Rome, Italy., Minisola F; Department of Urology, 'Regina Elena' National Cancer Institute, Rome, Italy., Ferriero M; Department of Urology, 'Regina Elena' National Cancer Institute, Rome, Italy., Romeo G; Department of Urology, 'Regina Elena' National Cancer Institute, Rome, Italy., Costantini M; Department of Urology, 'Regina Elena' National Cancer Institute, Rome, Italy., Al-Rawashdah SF; Urology Unit, Department of Special Surgery, Mutah University, Karak, Jordan., Guaglianone S; Department of Urology, 'Regina Elena' National Cancer Institute, Rome, Italy., Gallucci M; Department of Urology, 'Regina Elena' National Cancer Institute, Rome, Italy.
Jazyk: angličtina
Zdroj: International journal of urology : official journal of the Japanese Urological Association [Int J Urol] 2018 Jun; Vol. 25 (6), pp. 606-614. Date of Electronic Publication: 2018 Apr 16.
DOI: 10.1111/iju.13580
Abstrakt: Objectives: To describe our surgical technique and to report perioperative, 3-year oncological and functional outcomes of a single-center series of purely off-clamp robotic partial nephrectomy.
Methods: A prospective renal cancer institutional database was queried, and data of consecutive patients treated with purely off-clamp robotic partial nephrectomy between 2010 and 2015 in a high-volume center were collected. Perioperative complications, and 3-year oncological and functional outcomes were assessed. Univariable and multivariable analyses were carried out to identify independent predictors of renal function deterioration.
Results: Out of 308 patients treated, 41 (13.3%) experienced perioperative complications, 2.9% of which were Clavien grade ≥3. The 3-year local recurrence-free survival and renal cell carcinoma-specific survival rates were 99.5% and 97.9%, respectively. No patient with preoperative chronic kidney disease stage ≤3B developed severe renal function deterioration (chronic kidney disease stage 4) at 1-year follow up. At multivariable analysis, preoperative estimated glomerular filtration rate (P = 0.005) was the only independent predictor of a new-onset chronic kidney disease stage ≥3 in patients with preoperative chronic kidney disease stages 1 or 2.
Conclusions: Off-clamp robotic partial nephrectomy is a safe surgical approach in tertiary referral centers, with adequate oncological outcomes and negligible impact on renal function.
(© 2018 The Japanese Urological Association.)
Databáze: MEDLINE
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