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BMC Urology

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Open Access 01-12-2019 | Nephrectomy | Technical advance

Robotic-assisted partial nephrectomy with sequential clamping of segmental renal arteries for multiple ipsilateral renal tumors: initial outcomes

Authors: Jie Yang, Jia-dong Xia, Jian-xin Xue, Ning-hong Song, Chao Liang, Di Xi, Ya-min Wang, Zeng-jun Wang

Published in: BMC Urology | Issue 1/2019

Abstract

Background

To assess the technical feasibility and outcomes of robotic-assisted partial nephrectomy (RPN) with sequential segmental renal artery (SRA) clamping for multiple ipsilateral renal tumors (MIRTs).

Methods

From April 2016 to February 2018, consecutive eleven cases successfully underwent RPN with sequential SRA clamping under the guidance of dual-source computed tomography (DSCT).

Results

Ten cases had two lesions and two cases had three at the ipsilateral kidneys. The mean size and the mean R.E.N.A.L score for the dominant lesion of single case were 3.3 cm and 5.7, respectively. Twenty-two lesions (84.6%) had one target SRA and four (15.4%) had two target SRAs. Satisfactory ischemic areas were achieved by sequentially clamping two (81.8%) or three (18.2%) target SRAs with mean clamping time of 18.8 (15.0–27.0) min for single lesion, and the mean of total clamping time for single case was 37.5 (32.0–52.0) min. Only the complications of grade 1–2 were found and no positive surgical margin was discovered. The mean follow-up time was 5.4 months and no local recurrence or metastasis was found. The mean postoperative eGFR was 71.2 ml/minute/1.73m² that was only an insignificant reduction (9.3%) compared with the preoperative baseline.

Conclusion

This novel nephron-sparing technique, RPN with sequential SRA clamping, represents a good alternative for selected patients with MIRTs. With the guidance of DSCT and skilled robotic experience, this technique is feasible and can maximize renal function preservation. Large-scale multicenter clinical studies are still needed to further prove these initial outcomes.

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Title: Robotic-assisted partial nephrectomy with sequential clamping of segmental renal arteries for multiple ipsilateral renal tumors: initial outcomes
Authors: Jie Yang
Jia-dong Xia
Jian-xin Xue
Ning-hong Song
Chao Liang
Di Xi
Ya-min Wang
Zeng-jun Wang
Publication date: 01-12-2019
Publisher: BioMed Central
Keywords: Nephrectomy
Computed Tomography
Renal Cancer
Computed Tomography
Nephrectomy
Nephrectomy
Published in: BMC Urology / Issue 1/2019
Electronic ISSN: 1471-2490
DOI: https://doi.org/10.1186/s12894-019-0451-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Robotic-assisted partial nephrectomy with sequential clamping of segmental renal arteries for multiple ipsilateral renal tumors: initial outcomes

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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