• BACKGROUND: Robot-assisted partial nephrectomy can be performed through either a transperitoneal or retroperitoneal approach. (bvsalud.org)
  • In 1961, Schlegel et al first reported the usefulness of sonography in urology, for the detection of renal calculi . (medscape.com)
  • Intraoperative complications occurred in 4 (5.7%) patients but no conversion to open or laparoscopic surgery was required. (bvsalud.org)
  • PURPOSE: To report perioperative, renal function and oncological outcomes of robot-assisted radical nephroureterectomy (RNU) for patients with upper tract urothelial carcinoma (UTUC). (bvsalud.org)
  • CONCLUSION: We report favorable perioperative and oncological outcomes with expected decrease in renal function after robot-assisted RNU for patients with UTUC. (bvsalud.org)
  • Descriptive statistics with median and interquartile range (IQR) for continuous variables and numbers with frequencies for categorical variables were used to report perioperative and renal function outcomes while Kaplan-Meier curves were computed to present extravesical and intravesical recurrence-free survival(RFS) as well as cancer-specific (CSS) and overall survival (OS) with the corresponding 95% confidence intervals(CIs). (bvsalud.org)
  • With regards to renal function outcomes, the median postoperative loss in estimated glomerular filtration rate at discharge was 16 [10.25-26] mL/min/1.73 m2. (bvsalud.org)
  • The recommendations not met were using the Shouldice technique for any non-mesh open inguinal herniorrhaphy, using local anesthesia for open repair of reducible inguinal hernias, using lightweight mesh, and avoiding the use of prophylactic antibiotics in laparoscopic herniorrhaphy. (researchgate.net)
  • SDH-deficient renal cell carcinoma - clinical, pathologic and genetic correlates: a case report. (medscape.com)
  • Bilateral Xp11.2 translocation renal cell carcinoma: a case report. (medscape.com)
  • Spontaneous regression of adrenal metastasis from renal cell carcinoma after sunitinib withdrawal: case report and literature review. (medscape.com)
  • Renal cell carcinoma, of which clear cell carcinoma is the most common histological subtype (80 to 90 percent), comprises 90 percent of all Kidney tumors. (nih.gov)
  • Chronic kidney disease, renal transplantation, hemodialysis, acquired cystic kidney disease, a history of previous renal cell carcinoma, and co-existing diabetes mellitus have been recognized as potential risk factors associated with an increase in incidence in renal cell carcinoma in population-based studies. (nih.gov)
  • 34. Laparoscopic radical nephrectomy vs laparoscopic or open partial nephrectomy for T1 renal cell carcinoma: comparison of complication rates in elderly patients during the initial phase of adoption. (nih.gov)
  • Several important principles exist for performing NSS for renal cell carcinoma (RCC). (medscape.com)
  • The pathology reported a renal clear cell carcinoma, Furhman grade 2 with negative resection margins of 0.7 mm. (auanet.org)
  • Of this, 360 patients had stage T1 renal cell carcinoma (RCC) (302 with pT1a and 58 with pT1b) and met research criteria. (bvsalud.org)
  • We evaluated renal functional outcomes after sequential partial nephrectomy (PN) and radical nephrectomy (RN) in patients with bilateral renal cell carcinoma (RCC). (biomedcentral.com)
  • Approximately 85% of all kidney tumors are renal cell carcinoma (RCC). (biomedcentral.com)
  • However, many adrenal glands are removed en bloc as part of a radical nephrectomy for renal cell carcinoma . (medscape.com)
  • Non-ischemic laparoscopic partial nephrectomy using 1318-nm diode laser for small exophytic renal tumors. (medscape.com)
  • Clear cell renal cancer is the most common type of kidney cancer, comprising 80 percent of all malignant tumors found within the kidney. (nih.gov)
  • Clear cell tumors have the propensity to spread hematogenous, with direct extension into the major vessels - namely the renal veins and the inferior vena cava. (nih.gov)
  • [18] While angiomyolipoma is the most common renal neoplasm seen in patients with tuberous sclerosis, clear cell tumors may be seen rarely. (nih.gov)
  • 25. Comparison of laparoscopic and open partial nephrectomy in clinical T1a renal tumors. (nih.gov)
  • 30. Laparoscopic partial nephrectomy for tumors larger than 4 cm: a comparative study. (nih.gov)
  • 33. Laparoscopic partial nephrectomy for tumors 7cm and above. (nih.gov)
  • 39. Robotic versus laparoscopic partial nephrectomy for bilateral synchronous kidney tumors: single-institution comparative analysis. (nih.gov)
  • 40. Robot-assisted laparoscopic nephron sparing surgery for tumors over 4 cm: operative results and preliminary oncologic outcomes from a multicentre French study. (nih.gov)
  • Usually, only the renal artery is occluded, except in large centrally located tumors, in which the renal vein can be occluded to minimize bleeding and to allow for easier dissection and reconstruction. (medscape.com)
  • Partial nephrectomy uses a nephron-sparing approach and is increasingly becoming the gold standard for smaller tumors, tumors in solitary kidneys and patients with underlying poor renal function. (hindawi.com)
  • OBJECTIVES: There is lack of consensus in the Urology community regarding surveillance after laparoscopic partial nephrectomy (LPN), particularly for patients with stage I tumors. (bvsalud.org)
  • The surgery sequence should be prudently determined in bilateral renal tumors. (biomedcentral.com)
  • Nevertheless, several studies have elucidated renal functional outcomes in patients with bilateral synchronous tumors who have undergone sequential bilateral kidney surgery. (biomedcentral.com)
  • PN represents a suitable surgical approach for small renal tumors in favorable locations. (iospress.com)
  • The presentation and management of renal tumors has changed substantially during the last few decades. (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)
  • With this experience, surgeons have naturally started to push the envelope for partial nephrectomy to more complex cT1a tumors, and larger masses (cT1b and T2 tumors). (iospress.com)
  • Appropriately, this is necessary for patients with a solitary kidney, hereditary syndrome, known bilateral tumors, and significant chronic renal disease. (iospress.com)
  • The area of controversy and debate is in the optimal management of patients with cT1b and T2 tumors, normal renal function, and a normal contralateral kidney, and is the focus of the current article [ 6, 8 ]. (iospress.com)
  • METHODS: Data were collected on all laparoscopic partial nephrectomies performed at a single institution from January 2006 through May 2011. (bvsalud.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)
  • 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)
  • 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)
  • 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)
  • 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)
  • 27. Positive surgical margins in robot-assisted partial nephrectomy: a multi-institutional analysis of oncologic outcomes (leave no tumor behind). (nih.gov)
  • 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)
  • Patients were stratified based on the pathologic tumor stage at the time of partial nephrectomy. (bvsalud.org)
  • Synchronous bilateral RCCs were defined as diagnosis concomitantly or within 3 months of former tumor. (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)
  • Conversely, RN may be preferred in elderly patients with severe (non-renal related) comorbidities, in patients with an anatomically challenging tumor location, or for larger or locally advanced masses. (iospress.com)
  • Do not hesitate to use temporary renal artery occlusion and hypothermia, even for relatively small lesions. (medscape.com)
  • Partial nephrectomy (open or minimally invasive) usually requires temporary renal arterial occlusion to limit intraoperative bleeding and improve access to intrarenal structures. (hindawi.com)
  • Prepare iced slush saline for intraoperative renal cooling in anticipation of arterial occlusion and regional hypothermia. (medscape.com)
  • Temporary arterial occlusion and regional hypothermia are often necessary, depending on the size, location, and number of renal masses. (medscape.com)
  • Prepare patients being considered for nephron-sparing surgery (NSS) for possible radical nephrectomy. (medscape.com)
  • 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)
  • Nephron-sparing surgery should be considered for all amenable bilateral RCCs. (biomedcentral.com)
  • The purpose of this article is to characterize the rate of recurrence after partial nephrectomy in a low risk cohort. (bvsalud.org)
  • 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)
  • 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)
  • 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)
  • PATIENTS AND METHODS: Between August 2006 and August 2012 four women and two men (mean age 34.2 years) underwent right laparoscopic appendiceal onlay flap ureteroplasty. (bvsalud.org)
  • Both patients with recurrent pain underwent laparoscopic ureterolysis and bladder advancement flap proximal to the appendiceal onlay, which markedly improved one patient's pain but the other patient continued to have discomfort, ultimately resulting in a laparoscopic nephroureterectomy. (bvsalud.org)
  • There are limited data concerning patients treated with sequential bilateral kidney surgery. (biomedcentral.com)
  • In subgroup of bilateral RCCs, patients underwent sequential PN ( N = 48), PN followed by RN ( N = 8), or RN followed by PN ( N = 25). (biomedcentral.com)
  • Due to the relative rarity of bilateral presentation, even until now, there are limited data in the literature concerning patients treated with sequential bilateral kidney surgery. (biomedcentral.com)
  • It may also better preserve long-term renal function, particularly in patients who may need surgery for a contralateral kidney mass or have pre-existing chronic kidney disease. (iospress.com)
  • The patient's renin level should also be checked to rule out causes of secondary hyperaldosteronism, such as renal artery stenosis . (medscape.com)
  • The renin level is elevated in persons with renal artery stenosis, whereas the renin level is suppressed in those with primary hyperaldosteronism. (medscape.com)
  • Primary hyperaldosteronism can be secondary to an adrenal adenoma or secondary to bilateral adrenal hyperplasia. (medscape.com)
  • Ten percent of cases may be familial, and 10% might be bilateral or in extra-adrenal locations. (medscape.com)
  • The indication to perform PN has been expanded and RN is no longer the surgical treatment of choice for small, localized renal masses as reflected by current international guidelines [ 3, 6 ]. (iospress.com)
  • Optimal renal perfusion provided by a hydration regimen of approximately 200 mL/h or more of crystalloids overnight often is beneficial. (medscape.com)
  • 26. Management of renal masses with laparoscopic-guided radiofrequency ablation versus laparoscopic partial nephrectomy. (nih.gov)
  • The increasing use and quality of cross-sectional imaging has been associated with increased incidence, earlier detection and improved staging of renal masses [ 12 ]. (iospress.com)
  • Changes in renal papillary density after hydration therapy in calcium stone formers. (medscape.com)
  • A case of urinary bladder agenesis and bilateral ectopic ureters: a case report. (medscape.com)
  • It has been estimated that 73,800 new cases of cancers of the kidney and renal pelvis will be diagnosed in the United States in 2020 and that 14,800 people will die of them [ 1 ]. (biomedcentral.com)
  • 23. Laparoscopic partial nephrectomy at the Mayo Clinic Arizona: follow-up surveillance of positive margin disease. (nih.gov)
  • Multiparametric ultrasound: evaluation of greyscale, shear wave elastography and contrast-enhanced ultrasound for prostate cancer detection and localization in correlation to radical prostatectomy specimens. (medscape.com)
  • The effect of surgery report cards on improving radical prostatectomy quality: the SuRep study protocol. (medscape.com)
  • Surgical options include enucleation with a rim of normal parenchyma, wedge resection, polar nephrectomy, or bench surgery and autotransplantation (ex vivo). (medscape.com)
  • Summarize the role of history taking, physical examination, radiological investigations in the evaluation and management of clear cell renal cancer. (nih.gov)
  • Outline the options available in the management of clear cell renal cancer. (nih.gov)
  • 28. Laparoscopic partial nephrectomy: An experience in 227 cases. (nih.gov)
  • Developing a technique or drug that could reduce the risk of acute kidney injury associated with renal IRI would have an immediate worldwide impact on multisystem surgeries that would otherwise risk ischemic tissue injury. (hindawi.com)
  • In most cases in which preoperative imaging is optimized and the correct incision is used, partial nephrectomy can be performed in situ. (medscape.com)
  • Early vascular control is the key for minimizing blood loss and for prompting renal hypothermia, when necessary, in cases in which it was not originally planned. (medscape.com)
  • This is a time-critical step due to the critical ischemia period of renal tissue. (hindawi.com)
  • The two key factors that contribute to postoperative loss of renal function are ischemia time and degree of parenchymal loss [ 2 ]. (hindawi.com)
  • Although the precise pathophysiology of renal IRI is unclear, multiple pathways, which include generation of reactive oxygen species (ROS), apoptosis, hypoxia and associated inducible factors, or inflammation, are involved. (hindawi.com)
  • However, during ischemia the activity of the antioxidant enzymes is diminished, leading to an increase in the formation of superoxide radicals and oxidative stress at reperfusion [ 9 ]. (hindawi.com)
  • Predicting 90-day and long-term mortality in octogenarians undergoing radical cystectomy. (medscape.com)
  • Ultrasonography can guide the incision in the renal capsule and identify the shortest and easiest access to the lesion that compromises and sacrifices the least amount of normal parenchyma. (medscape.com)
  • The free radicals damage proteins, lipids, and DNA, leading to further impairment of mitochondrial function and cell death. (hindawi.com)
  • Moreover, sequential PN subgroup in bilateral RCC showed significantly higher rate of de novo CKD than unilateral RCC group (13.8% vs. 6.9%, p = 0.016). (biomedcentral.com)
  • PN followed by RN showed a negative impact on renal functional preservation. (biomedcentral.com)
  • Lower the surface and core renal temperature to minimize ischemic damage to the kidney. (medscape.com)