Nephrectomies in Saudi Arabia: A Comprehensive Analysis of Outcomes from a High-Volume Minimally Invasive Surgery Center.

Autor: Alasker A; College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia.; Department of Urology, King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia.; Department of Medicine, King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia., Alnafisah TR; College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia., Shafqat A; College of Medicine, Alfaisal University, Riyadh, Kingdom of Saudi Arabia., Sabbah BN; College of Medicine, Alfaisal University, Riyadh, Kingdom of Saudi Arabia., Alaswad M; College of Medicine, Alfaisal University, Riyadh, Kingdom of Saudi Arabia., Alghafees M; College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia., Alhaider A; Department of Urology, King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia., Alsayyari A; Department of Urology, King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia., Althonayan N; Department of Urology, King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia., Al-Otaibi M; College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia., Ofisan SB; College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Kingdom of Saudi Arabia., Alharbi MG; College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia., Alsaikhan B; College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia.; Department of Urology, King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia.; Department of Medicine, King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia., Al-Khayal A; College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia.; Department of Urology, King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia.; Department of Medicine, King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia.
Jazyk: angličtina
Zdroj: Journal of kidney cancer and VHL [J Kidney Cancer VHL] 2024 Jul 18; Vol. 11 (3), pp. 1-12. Date of Electronic Publication: 2024 Jul 18 (Print Publication: 2024).
DOI: 10.15586/jkcvhl.v11i3.332
Abstrakt: Literature reporting on the outcomes of the different procedures of nephrectomies (open vs laparoscopic vs robotic) in Saudi Arabia remains limited. Compare surgical and oncological outcomes between open and minimally invasive nephrectomies. A retrospective cohort study. The present study included all adult patients who underwent nephrectomies between January 1, 2015 and January 31, 2023. We collected demographic, preoperative, intraoperative, and postoperative data on 408 adult cancer patients who underwent nephrectomies at our center between January 2015 and January 2023. Statistical differences were calculated between procedure types. Overall survival was calculated using Kaplan-Meier curves with log-rank tests. P<0.05 was considered statistically significant. Measures of operative success (intraoperative blood loss, intraoperative and postoperative complications, and hospital stay) and oncological outcomes (local recurrence, metastatic progression, and chemotherapy use) between different procedure and nephrectomy types for cancer patients. A total of 408 cancer patients underwent nephrectomies. In cancer patients, open nephrectomy was associated with significantly higher intraoperative blood loss (p<0.001), incidence of blood transfusions (p<0.001), hospital stay (p<0.001), intraoperative complications (p=0.027 and p=0.001, respectively), local recurrence (p<0.001), metastatic progression (p=0.001), and chemotherapy (p=0.001) than minimally invasive surgery, but survival differences across procedure types were not statistically significant (log-rank p-value = 0.054). Regarding nephrectomy type, significant differences were observed in tumor size (p < 0.001), initial procedure type (p<0.001), operation time (p<0.001), blood transfusion (p=0.033), length of hospital stay (p=0.004), intraoperative complications (p=0.020), postoperative complications (p=0.025), Clavien classification (p=0.003), mortality (p=0.022), metastatic progression (p<0.001), and chemotherapy use (p=0.001) between simple/total nephrectomy, radical nephrectomy (RN), partial nephrectomy (PN), and nephroureterectomy. Survival differences between the four nephrectomy types were statistically significant (log-rank p value = 0.001). Minimally invasive nephrectomies reduce inpatient morbidity while conferring equivalent oncological and surgical outcomes.
Competing Interests: The authors declare that there are no conflicts of interest.
(Copyright: Sabbah B.N., et al.)
Databáze: MEDLINE
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