Ischemia time during open nephron sparing open partial nephrectomy. Medical search. Frequent questions

Comparison of 1,800 laparoscopic and open partial nephrectomies for single renal tumors. (ac.ir)
Recent reports have shown the efficacy of robot-assisted partial nephrectomy (RAPN) compared with open and laparoscopic surgery for difficult cases such as hilar, endophytic or large tumors. (elsevierpure.com)
Although the indication of RAPN for renal tumors has expanded, there are some cases where we have to decide to perform radical nephrectomy for oncological safety. (elsevierpure.com)
Increasingly, renal cell cancers are diagnosed at an earlier stage, and nephron-sparing surgery and thermal ablation are gaining acceptance as a treatment of choice for smaller tumors. (medscape.com)
Radical nephrectomy is the standard for larger and central tumors. (medscape.com)

This study aimed to document the surgical and oncologic results of nephron sparing of non-ischemic laparoscopic partial nephrectomy without the step of hilus controlling and even without dissecting to expose the main renal vascularity and directly focusing on mass removal. (ac.ir)
The records of the patients who underwent our modified laparoscopic partial nephrectomy technique were evaluated retrospectively. (ac.ir)
Robotic versus laparoscopic partial nephrectomy: a systematic review and meta-analysis. (ac.ir)
Laparoscopic partial nephrectomy without ischemia. (ac.ir)
Running-clip renorrhaphy reducing warm ischemic time during laparoscopic partial nephrectomy. (ac.ir)
Touma NJ, Matsumoto ED, Kapoor A. Laparoscopic partial nephrectomy: The Mc Master University experience. (ac.ir)
Multicenter experience with nonischemic multiport laparoscopic and laparoendoscopic single-site partial nephrectomy utilizing bipolar radiofrequency ablation coagulator. (ac.ir)
Studies providing sufficient details on renorrhaphy techniques during laparoscopic or robot‐assisted partial nephrectomy and comparative studies focused on peri‐operative outcomes were included in qualitative and quantitative analyses, respectively. (bjuinternational.com)

Acar Ö, Esen T, Musaoğlu A, Vural M. Do we need to clamp the renal hilum liberally during the initial phase of the learning curve of the robot assisted nephron-sparing surgery? (ac.ir)
Specific tumour features (i.e. size, hilar location, anatomical complexity, nearness to renal sinus and/or urinary collecting system), surgeon's experience, robot‐assisted technology, as well as the aim of reducing warm ischaemia time and the amount of devascularized renal parenchyma preserved represented the key factors driving the evolution of the renorrhaphy techniques during MIPN over the past decade. (bjuinternational.com)

Ancak özellikle postoperatif renal fonksiyon kaybı için en önemli gösterge hastaya ait komorbiditeler olacaktır. (urolojihekimleri.org)
Present un-controlled results pointed that tumor-focusing nephron-sparing non-ischemic partial lap-aroscopic nephrectomy may be preferable for small-sized, low-complex renal masses. (ac.ir)
Evaluation of renal function under controlled hypotension in zero ischemia robotic assisted partial nephrectomy. (ac.ir)
Since a decrease in renal function can lead to an increase in the risk of cardiovascular events and patient death due to the development of chronic kidney disease, we need to select a suitable treatment that includes active surveillance, ablation therapy and partial nephrectomy for nephron sparing. (elsevierpure.com)
Integrated overview of evidence‐based technical principles for renal reconstruction during minimally invasive partial nephrectomy and suggested standardized reporting of key renorrhaphy features in clinical studies on this topic. (bjuinternational.com)

Severe ischemic nephropathy was detected in the nephrectomy material. (peertechzpublications.com)

A systematic review of the literature was performed in January 2018 without time restrictions, using MEDLINE, Cochrane and Web of Science databases according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses statement recommendations. (bjuinternational.com)

Quantitative synthesis showed that running suture was associated with shorter operating and ischaemia time, and lower postoperative complication and transfusion rates than interrupted suture. (bjuinternational.com)

To summarize the available evidence on renorrhaphy techniques and to assess their impact on peri‐operative outcomes after minimally invasive partial nephrectomy (MIPN). (bjuinternational.com)

Mean operation time, estimated blood loss, and transfusion rates were 138.62 ± 38.45 minutes (range: 90-240 min), 242.24 ± 107.12 mL (range: 100-500 mL), and 19%, respectively. (ac.ir)

Nephron-Sparing Surgery, In: Smith AD (ed): Smith's Textbook of Endourology, New York: Wiley-Blackwell Publication, 2012, pp:1014-24. (ac.ir)
Hematoma was removed with surgery but developed again and left nephrectomy was required. (peertechzpublications.com)

Furthermore, some reports have suggested that one of the factors for trifecta achievement, which was defined as negative surgical margins, freedom from perioperative complications, and an short ischemia time, is the experience of the surgeon who will carry out the procedure. (elsevierpure.com)

Prolonged prothrombin time with hemorrhagic diathesis which coexisting thrombosis responded steroid therapy. (peertechzpublications.com)

Barbed suture had lower operating and ischaemia time and less blood loss than non‐barbed suture. (bjuinternational.com)

The abstract is reproduced below and you can click on the button to read the full article, which is freely available to all readers for at least 30 days from the time of this post. (bjuinternational.com)
If you only have time to read one article this week, it should be this one. (bjuinternational.com)

The cellular defects in ADPKD that have been known for a long time are increased cell proliferation and fluid secretion, decreased cell differentiation, and abnormal extracellular matrix. (basicmedicalkey.com)

In patients' follow-up, prolonged prothrombin time (PT), activated partial thromboplastin time (PTT) and thrombocytopenia were developed. (peertechzpublications.com)

Open radical nephrectomy is the traditional treatment for a renal neoplasm, but open partial nephrectomy has evolved into a standard of care, with the obvious advantage of sparing the kidney. (medscape.com)
Robotic radical prostatectomy has become the prime example in which a complex open procedure may be reproduced with robotic assistance in a minimally invasive fashion. (medscape.com)
For 5 decades, the recommended treatment was complete removal of the kidney (radical nephrectomy),[2] which was effective but associated with an increased risk of chronic renal failure. (medscape.com)
8] The National Comprehensive Cancer Network (NCCN) recommends partial nephrectomy for a T1a renal mass, stating that radical nephrectomy should not be used when nephron-sparing approaches are possible. (medscape.com)
For T1b tumors, the NCCN guideline states that the standard of care is either radical nephrectomy or partial nephrectomy (when possible). (medscape.com)
None of the cases was converted to open partial/radical nephrectomy and none had positive surgical margins in the histopathology reports. (asmepress.com)
The European Organization for Research and Treatment of Cancer" provided the first Level I evidence that long-term oncologic outcomes between partial nephrectomy and radical nephrectomy were equivalent, allowing partial nephrectomy to become a standard of care for small renal masses [2]. (asmepress.com)
We evaluated renal functional outcomes after sequential partial nephrectomy (PN) and radical nephrectomy (RN) in patients with bilateral renal cell carcinoma (RCC). (biomedcentral.com)
have demonstrated that bilateral partial nephrectomy (PN) is associated with significantly improved estimated glomerular filtration rate (eGFR) compared to radical nephrectomy (RN) [ 6 ]. (biomedcentral.com)
The decision to undergo partial nephrectomy (PN) versus radical nephrectomy (RN) for a localized renal mass should take various factors into consideration, including tumor characteristics, patient's health status and preference, and risks and benefits of these each approach. (iospress.com)
Laparoscopic radical nephrectomy (RN) should be offered to patients with locally advanced tumor growth or in T1 tumors with unfavorable location [ 6 ]. (iospress.com)
Comparisons between radical (RN) or partial nephrectomy (PN) and young or elderly patients were performed. (biomedcentral.com)

14. Sliding-clip technique for renorrhaphy improves perioperative outcomes of open partial nephrectomy. (nih.gov)
As the technique of RAPN (robotic-assisted partial nephrectomy) continues to develop and mature, intraoperative & perioperative outcomes continue to be reported [4]. (asmepress.com)
Robotic and laparoscopic partial nephrectomy has been shown to be similar in perioperative outcomes which include warm ischemia time, surgical margins, and complications. (puaweb.org)

Partial nephrectomy (open or minimally invasive) usually requires temporary renal arterial occlusion to limit intraoperative bleeding and improve access to intrarenal structures. (hindawi.com)
The quest for trifecta comprising warm ischemia time less than 25 minutes, negative surgical margins and no perioperative complications seems to be better accomplished by robotic partial nephrectomy, which is likely to become the new standard for minimally invasive partial nephrectomy. (asmepress.com)
Although open partial nephrectomy is an efficacious procedure, a minimally invasive approach might be more attractive to patients [3]. (asmepress.com)
The first part of the plenary focused on the minimally invasive techniques in partial nephrectomy. (puaweb.org)
This is especially true in contemporary practice as experience in partial nephrectomy grows, primarily driven by the rise of robotic minimally-invasive surgery. (iospress.com)

In the 1980s and 1990s, reports of the feasibility of laparoscopic renal surgery were published,[13, 14] with the first hand-assisted laparoscopic nephrectomy performed in 1997. (medscape.com)
Multiple series have now demonstrated excellent long-term cancer outcomes for laparoscopic nephrectomy. (medscape.com)
Robotic and laparoscopic nephrectomy were showcased in both lectures. (puaweb.org)

In efforts to reduce the morbidity of open surgery, surgeons developed laparoscopic partial nephrectomy, with the initial large series showing excellent cancer-specific outcomes[10] but higher complication rates than open surgery. (medscape.com)
With improvements in robotic technology for surgery, robotic-assisted partial nephrectomy (RPN) has emerged as a preferred technique, with excellent short-term cancer and functional outcomes and decreased morbidity in selected patients. (medscape.com)
With the evolution of robotic technology for surgery, robotic-assisted partial nephrectomy has evolved as a technique that offers similar outcomes to laparoscopic or open techniques but that may have the advantage of improved maneuverability and precision to decrease ischemia times and improve postoperative renal function. (medscape.com)
Objective: To report our experience of salvage PN for local recurrence after previous nephron-sparing surgery (NSS). (bvsalud.org)
10. Use of self-retaining barbed sutures decreases cold ischemia time in open nephron-sparing surgery. (nih.gov)
However, while the majority of cancers are suitable for partial nephrectomy, concern about the warm ischemia time has meant that only around 25% of small kidney cancers are treated with nephron-sparing surgery [ 3 ]. (hindawi.com)
A pharmacological agent that could reduce the risk of IRI and prolong the "safe" warm ischemia time would cause a global transformational change in the utilization of partial nephrectomy, with broader implications for renal transplantation, cardiac surgery, and the myriad other surgeries that involve IRI. (hindawi.com)
As such most current renal tumours are incidentally detected, asymptomatic and quite amendable to nephron-sparing surgery [1]. (asmepress.com)
Recently there have been several reports indicating that robotic surgery facilitates the resection of the tumour and intracorporeal suturing thus decreasing the warm ischemia time [6-8]. (asmepress.com)
Nephron-sparing surgery should be considered for all amenable bilateral RCCs. (biomedcentral.com)
In a female patient, we performed a robotic anatrophic nephron-sparing surgery for complete intrarenal tumor in the renal sinus through the avascular line. (auanet.org)
The increase of partial nephrectomies performed was attributable to robotic assisted surgery that increased by 15%, with a concomitant decrease of open surgery by 33% [ 7 ]. (iospress.com)

In this communication we describe the surgical outcomes of 35 patients undergoing robotic partial nephrectomy. (medscape.com)
Robotic partial nephrectomy can produce excellent initial results. (medscape.com)
16. Robotic partial nephrectomy with sliding-clip renorrhaphy: technique and outcomes. (nih.gov)
18 years with a renal tumour of clinical stage T1 coming for robotic partial nephrectomy. (asmepress.com)

17. Perioperative and renal functional outcomes of laparoscopic partial nephrectomy (LPN) for renal tumours of high surgical complexity: a single-institute comparison between clampless and clamped procedures. (nih.gov)
We aimed to compare the surgical, oncological, and functional outcomes of robot-assisted partial nephrectomy (RAPN) with open partial nephrectomy (OPN) in the management of small renal masses. (nih.gov)

Therefore, partial nephrectomy requires precise control for excision and prompt repair to minimize bleeding and to decrease ischemic time to the kidney. (medscape.com)
11. Running-clip renorrhaphy reducing warm ischemic time during laparoscopic partial nephrectomy. (nih.gov)

The open and laparoscopic approaches have been well described in the literature. (medscape.com)
[ 1 ] In the 1990s laparoscopic approaches to partial nephrectomy were developed. (medscape.com)

Measurements: Operative time, warm ischemia time, and intra- and postoperative complications were recorded. (bvsalud.org)
Their results are rather impressive in terms of operating times, intra- and postoperative complications and renal function preservation, making this technique a further advance in the surgical treatment of small renal masses. (unifi.it)

Patients' demographics, mean operative time, estimated blood loss (EBL), warm ischemia time (WIT), length of hospital stay, pre- and post-operative renal functions, complications and oncological outcomes were recorded, prospectively. (nih.gov)

16] As laparoscopic techniques evolved, several authors demonstrated the feasibility[17] and favorable outcomes with laparoscopic partial nephrectomy performed by experienced laparoscopic surgeons. (medscape.com)
With a relatively favorable learning curve (25 cases), dissemination of robotic assisted technology and has led to increased use of partial nephrectomy, from 8.6% in 2000 to 27% in 2011 [ 7 ]. (iospress.com)

Mean warm ischemia time was 20 minutes. (medscape.com)
[ 4 ] However, the operation has also been thought to be technically advanced secondary to the laparoscopic reconstructive skills necessary to perform the procedure quickly while the kidney is under warm ischemia. (medscape.com)
The median operative time was 177 (IQR 148-200) min, and hilar clamping was performed in 14 (53.8%) cases with a median warm ischemia time of 16 (14.5-22) min. (bvsalud.org)
2. Self-retaining barbed suture reduces warm ischemia time during laparoscopic partial nephrectomy. (nih.gov)
7. The use of self-retaining barbed suture for inner layer renorrhaphy significantly reduces warm ischemia time in laparoscopic partial nephrectomy: outcomes of a matched-pair analysis. (nih.gov)
Current clinical data support a "safe" warm ischemia time of 25 minutes, or a cold ischemia time (when the kidney is placed on ice slush) of 35 min while up to two hours can be tolerated [ 4 ]. (hindawi.com)
Mean Warm Ischemia Time (WIT) was recorded to be 27.28 ± 5.923 minutes. (asmepress.com)
The operative time was 270 minutes, warm ischemia time was 25 minutes, estimated blood loss was 200 ml and hospital stay was 4 days. (auanet.org)

Patient summary: Robotic redo partial nephrectomy is a challenging procedure. (bvsalud.org)

The mean operative time was 152 min in OPN group and 225 min in RAPN group (P = 0.006). (nih.gov)
The mean total operative time was noted to be 167.00 ± 21.116 minutes. (asmepress.com)

Objectives: Endoscopic submucosal dissection (ESD) is an effective procedure for the en bloc resection of colorectal neoplasms. (bvsalud.org)

Further studies should be performed to compare the outcomes to laparoscopic and open operations. (medscape.com)

Although a large number of drugs and agents (including Ca 2+ -channel blockers, mannitol, acadesine, adenosine, Na + /H + -exchange inhibitors, and N-acetylcysteine (an antioxidant)) have been shown to protect against ischemia-reperfusion injury (IRI) in the kidney in vitro and in vivo (in either rat or mouse), all have failed in either large animal or human trials [ 5 - 8 ]. (hindawi.com)
Urethra is more sensitive to ischemia than bladder: evidence from an in vitro rat study. (upstate.edu)

Prolonged renal ischemia may lead to irreversible nephron damage in the remaining tissue and, ultimately, chronic kidney disease. (hindawi.com)
Beyond this period, critical ischemia ensues, where renal cells are irreversibly injured, eventually resulting in nephron loss and chronic kidney disease in 5-17% patients [ 4 ]. (hindawi.com)

A standard of care for the treatment of small renal masses is partial nephrectomy. (medscape.com)

15. Ring Suture Technique in Retroperitoneal Laparoscopic Partial Nephrectomy for Hilar Cancer: A New Renorrhaphy Technique. (nih.gov)

9. Comparison of two different renorrhaphy techniques in retroperitoneal laparoscopic partial nephrectomy for complex tumor. (nih.gov)
The aim of this review is to highlight the techniques and drugs that target HIF-1 α and ameliorate IRI associated with renal ischemia. (hindawi.com)

13. Evolving renorrhaphy technique for retroperitoneal laparoscopic partial nephrectomy: single-surgeon series. (nih.gov)

examining a large cohort of Medicare beneficiaries, increase rates of computed tomography (CT) imaging was associated with a higher risk of nephrectomy, presumably from incidental detection of renal masses, with little change in morality [ 4 ]. (iospress.com)

Robotic assistance may augment partial nephrectomy by aiding in dissection and renal reconstruction. (medscape.com)

12. The unidirectional barbed suture for renorrhaphy during laparoscopic partial nephrectomy: Stanford experience. (nih.gov)

The mean drain removal time and the length of hospital stay were longer in OPN group. (nih.gov)

Indeed, it remains of utmost importance to explore new ways to face this surgical step, in order to minimize or even eliminate the detrimental effect of renal ischaemia. (unifi.it)

6. Partial nephrectomy: is there an advantage of the self-retaining barbed suture in the perioperative period? (nih.gov)

Mean tumor size was 2.8cm, and mean OR time was 142 minutes. (medscape.com)

Anatomy12

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