Radical nephrectomyHilarPartialLaparoscopicClear cell renal cell carcKidneyComplicationsRAPNPosteriorRobot-assistedVenousPreoperativeSurgical approachComplexitySurgeryPatientsSizeManagementTreatmentTimeRadicalResectionMinimallyWarm ischemiaRenal parenchymaKidneyRobotic technologyBiopsyFavorableParenchymaIntraoperative ultrasoundPapillarySurgicalApproachCompletelyCasesLargeInitial
Radical nephrectomy13
- Although robot-assisted radical nephrectomy and IVC thrombectomy has been shown to be feasible, the literature is limited. (auanet.org)
- We present our initial experience with robot-assisted radical nephrectomy and IVC thrombectomy that includes one case that involved a synthetic vena caval patch repair. (auanet.org)
- Six patients underwent robot-assisted radical nephrectomy and IVC thrombectomy by a single surgeon (DDE) between October 2009 and January 2012. (auanet.org)
- In appropriately selected candidates, robot-assisted radical nephrectomy with IVC thrombectomy is feasible. (auanet.org)
- Nephron-sparing techniques independently decrease the risk of cardiovascular events relative to radical nephrectomy in patients with a T1a-T1b renal mass and normal preoperative renal function. (ac.ir)
- Oncological outcomes of minimally invasive partial versus minimally invasive radical nephrectomy for cT1-2/N0/M0 clear cell renal cell carcinoma: a propensity score-matched analysis. (ac.ir)
- Mir MC, Derweesh I, Porpiglia F, Zargar H, Mottrie A, Autorino R. Partial Nephrectomy Versus Radical Nephrectomy for Clinical T1b and T2 Renal Tumors: A Systematic Review and Meta-analysis of Comparative Studies. (ac.ir)
- 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)
- 6 Overall survival of patients with T1b tumors may also be better when compared to radical nephrectomy based on data from the National Cancer Database. (auanews.net)
- Overall survival of patients with T1b tumors may also be better when compared to radical nephrectomy. (auanews.net)
- However, partial nephrectomy can be technically challenging because of intraoperative hemorrhage, which limits the ability to identify the tumor margin and may necessitate the conversion to open surgery or radical nephrectomy. (biomedcentral.com)
- During this stressful situation, it is imperative for the surgeon to have an organized approach to management of hemorrhage, as delayed management could lead to prolonged ischemic times, iatrogenic positive surgical margins from inadequate visualization, conversion to open surgery, or radical nephrectomy. (biomedcentral.com)
- Surgical treatment of renal tumors with clinical cT1b stage is the radical nephrectomy. (journal-imab-bg.org)
Hilar5
- 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)
- Polar flip" technique for transperitoneal laparoscopic partial nephrectomy - Evolution of a novel technique for posterior hilar 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)
- Partial nephrectomy for T1b tumors is expected to be complex and must have good preoperative imaging to determine the location of the mass in relation to the hilar vessels. (auanews.net)
- Table 1 Selected reports from 2009-2012 of estimated blood loss during robotic partial nephrectomy with hilar clamping. (biomedcentral.com)
Partial34
- 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)
- 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)
- 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)
- BACKGROUND: In the surgical management of kidney tumors, such as in multiport technology, single-port (SP) robotic-assisted partial nephrectomy (RAPN) can be performed using the transperitoneal (TP) or retroperitoneal (RP) approach. (bvsalud.org)
- Robotic-assisted partial nephrectomy (RAPN) is a surgery to remove a portion of the kidney due to kidney cancer. (bvsalud.org)
- International Expert Consensus on Metric-based Characterization of Robot-assisted Partial Nephrectomy. (providence.org)
- To propose a standardized scoring system of renal tumors suitable for partial nephrectomy based on mini-invasiveness and retroperitoneal approach. (ac.ir)
- The RETRO score simplifies the risk evaluation of partial nephrectomy for patients with renal tumor, especially benefits those surgeries performed under robot-assisted laparoscope via retroperitoneal approach. (ac.ir)
- The new RETRO score system that we developed is a selection criterion to perform surgery via different approach, and an accurate system to evaluate the complexity during partial nephrectomy. (ac.ir)
- Expanding the limits of nephron-sparing surgery: Surgical technique and mid-term outcomes of purely off-clamp robotic partial nephrectomy for totally endophytic renal tumors. (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)
- Manage bleeding complications of robotic partial nephrectomy. (auanews.net)
- Minimize positive margin rates of robotic partial nephrectomy. (auanews.net)
- For T1b renal masses, partial nephrectomy results in improved postoperative renal function with equivalent oncologic outcomes, though the complication rate and blood loss are expected to be greater. (auanews.net)
- 7 Hence partial nephrectomy may be performed in these patients after considering tumor location and complexity, patient factors such as comorbidities, and renal function and surgeon experience. (auanews.net)
- The robotic and open approach for partial nephrectomy is based on surgeon experience and can have equivalent oncologic outcomes. (auanews.net)
- Five weeks ago I left hospital after undergoing an open partial nephrectomy to remove a suspicious 3cm tumour from my right kidney. (adjb.net)
- The adoption of robotic assistance has contributed to the increased utilization of partial nephrectomy for the management of renal tumors. (biomedcentral.com)
- To our knowledge, a comprehensive safety checklist does not exist to guide surgeons on the management of hemorrhage during robotic partial nephrectomy. (biomedcentral.com)
- A treatment safety checklist for the management of hemorrhage during robotic partial nephrectomy was collaboratively developed based on prior experiences with intraoperative hemorrhage during robotic partial nephrectomy. (biomedcentral.com)
- Reducing the risk of hemorrhage during robotic partial nephrectomy begins with reviewing the preoperative imaging for renal vasculature and tumor anatomy, with a focus on accessory vessels and renal tumor proximity to the renal hilum. (biomedcentral.com)
- Safely performing robotic partial nephrectomy is dependent on attention to prevention of hemorrhage and rapid response to the challenge of intraoperative bleeding. (biomedcentral.com)
- Preparation is essential for maximizing the chance of success during robotic partial nephrectomy. (biomedcentral.com)
- During partial nephrectomy, in which part of the kidney is removed for a renal tumor, hemorrhage can be particularly troublesome because the kidney is a well perfused organ and renal cell carcinomas are associated with increased vascularity [ 1 ]. (biomedcentral.com)
- Traditionally, partial nephrectomy had been performed via an open approach but there has been a steady trend toward a minimally invasive approach [ 2 ]. (biomedcentral.com)
- As partial nephrectomy is increasingly performed with a minimally invasive approach, control of intraoperative hemorrhage can be more challenging than simple manual compression of the renal parenchyma with suturing, as can be done in open surgery. (biomedcentral.com)
- Series on robotic partial nephrectomy report a reasonable blood loss (Table 1 ). (biomedcentral.com)
- Thus, the existing literature does little to educate surgeons on how to deal with bleeding during robotic partial nephrectomy while clamped. (biomedcentral.com)
- The goal of this manuscript is to educate robotic surgeons in factors to minimize hemorrhage during robotic partial nephrectomy. (biomedcentral.com)
- We then developed a safety and management checklist for "hemorrhage while clamped" during robotic partial nephrectomy. (biomedcentral.com)
- Since that time, the authors have performed a total of over 1500 robotic partial nephrectomies. (biomedcentral.com)
- Partial nephrectomy is considered to be a gold standard in the surgical treatment of small kidney masses in stage 1 cT1b. (journal-imab-bg.org)
- When establishing a patient with renal tumor in the cT1b stage the first treatment line should be partial nephrectomy. (journal-imab-bg.org)
- Partial nephrectomy is associated with perioperative complications in about 20% of cases, which causes significant comorbidity. (journal-imab-bg.org)
Laparoscopic1
- The purpose of this report is to analyze our initial clinical experience with laparoscopic cryoablation of kidney tumors and to investigate how effective and safe this method is. (journal-imab-bg.org)
Clear cell renal cell carc1
- This trial examined adjuvant pembrolizumab after nephrectomy in clear cell renal cell carcinoma. (auanews.net)
Kidney3
- Kidney tumor location measurement using the C index method. (ac.ir)
- The tumour is categorized as Stage 1 (on a scale of 1 - 4) - that is, small and completely contained within the kidney. (adjb.net)
- Renal cryoablation is a recommended therapeutic alternative in a specific patient population, namely elderly patients, patients with multiple concomitant diseases, single kidney patients, ipsilateral multiple kidney tumors or patients with bilateral renal tumors. (journal-imab-bg.org)
Complications1
- Symptoms, ASA score and RETRO score were significantly correlated to postoperative complications, excluding tumor size, ischemia time and operation time. (ac.ir)
RAPN1
- CONCLUSIONS: With proper patient selection based on patient and tumor characteristics, surgeons can opt for either the TP or the RP approach for SP RAPN, and maintain satisfactory outcomes. (bvsalud.org)
Posterior1
- RP had a significantly higher proportion of posterior tumors (54 [55.10%] RP vs 28 [23.14%] TP, p (bvsalud.org)
Robot-assisted1
- Baseline characteristics and tumor stages distribution were comparable in the two groups but those receiving a robot-assisted approach showed significantly reduced times to flatus, bowel and hospital discharge (all p (uniroma1.it)
Venous1
- Segmental venous involvement with tumor thrombus on preoperative imaging as well as during surgery must be looked for and managed appropriately, if present for T1b and T2 neoplasms. (auanews.net)
Preoperative1
- Endophytic masses will need a preoperative ultrasound to determine its echogenicity to enable optimal intraoperative imaging. (auanews.net)
Surgical approach1
- Minimally invasive nephron sparing surgery has become increasingly popular as expertise in laparoscopy has increased and has demonstrated excellent long-term renal functional and oncological outcome, The da Vinci ® surgical system may facilitate performing these complex renal tumors using the minimally invasive surgical approach. (mountsinaiurologycme.org)
Complexity1
- Zonal NePhRO Scoring System: A Superior Renal Tumor Complexity Classification Model. (ac.ir)
Surgery1
- As of August 2021, a new anti-HIF-2alpha approach is now U.S. Food and Drug Administration (FDA) approved for nonmetastatic von Hippel-Lindau-associated tumors not requiring immediate surgery. (auanews.net)
Patients4
- The limit of tumor extension was level I in 3 (50.0%) patients, level II in 1 (16.7%) patient, and level III in 2 (33.3%) patients. (auanet.org)
- Patients were included if they were determined to have (after nephrectomy) pathological stage T3 or higher tumors (or node positive tumors) or pathological T2 tumors with nuclear grade 4, or T2 tumors with sarcomatoid differentiation. (auanews.net)
- However, treatment guidelines have recently changed in patients with renal tumors with cT1b. (journal-imab-bg.org)
- Following the introduction of renal cryoablation at the end of the 1990s, urologists broadened the role of cryoablation to treat cT1b stage tumors in selected patients. (journal-imab-bg.org)
Size2
- On pathologic analysis, mean tumor size was 8.2 cm (range 5.8-12). (auanet.org)
- The R.E.N.A.L. nephrometry score: a comprehensive standardized system for quantitating renal tumor size, location and depth. (ac.ir)
Management1
- 4. Lee CT, Katz J, Shi W, Thaler HT, Reuter VE, Russo P. Surgical management of renal tumors 4 cm or less in a contemporary cohort. (journal-imab-bg.org)
Treatment1
- Long-term oncological and functional outcome is important in the treatment of small renal tumors. (elsevierpure.com)
Time1
- Hemorrhage is further concerning as control can occupy valuable time during which the renal unit is ischemic due to renal vascular clamping during tumor excision. (biomedcentral.com)
Radical2
- We prospectively collected radical nephrectomy (RN) specimens, to analyze the histological changes within peritumoral and distant parenchyma. (biomedcentral.com)
- Our study exclusively enrolled radical nephrectomy (RN) specimens to better assess the non-neoplastic parenchyma, including the tumor pseudo-capsule (PC), peritumoral parenchyma and distant parenchyma. (biomedcentral.com)
Resection2
- 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)
- Identify the role of cytoreductive nephrectomy and/or resection of metastatic foci in patients with advanced disease. (auanet.org)
Minimally1
- Attendees will integrate knowledge of tumor biology to choose between minimally invasive surgical enucleation techniques for indolent cancers versus open surgical approach with wide margins for aggressive forms of RCC. (auanet.org)
Warm ischemia1
- Warm ischemia time ranged from 20-26 min in parahilar tumors and 15-20 min in midpolar and polar tumors. (vattikutifoundation.com)
Renal parenchyma5
- however on the other hand, the amount of residual healthy renal parenchyma strongly depends on the tumour size and location. (amedi.sk)
- With use of robotic technology, these tumors can be operated with less perioperative morbidity, and maximal preservation of normal renal parenchyma in the patient. (vattikutifoundation.com)
- They will differentiate between indolent and slow growing tumors, such as clear cell RCC, type 1 papillary RCC and chromophobe RCC, and more aggressive tumors, such as type 2 papillary RCC and TFE3 RCC which can infiltrate into the renal parenchyma and have a propensity to spread when the tumors are small. (auanet.org)
- A compression band filled with severe histological changes was typically observed in renal parenchyma close to the tumor. (biomedcentral.com)
- To fully understand the histological changes of the renal parenchyma in RCC, peritumoral parenchyma and distant parenchyma, as well as the pattern of tumor invasion within the renal parenchyma, should be more thoroughly examined. (biomedcentral.com)
Kidney2
- Open nephrectomy for kidney tumors can be performed through a flank, subcostal, or midline abdominal incision. (medscape.com)
- The role of surgery in patients with advanced RCC with the primary kidney tumor in place will be discussed, i.e., when to recommend cytoreductive nephrectomy and when to recommend immediate systemic therapy. (auanet.org)
Robotic technology1
- We have discussed our approach of managing these tumors using robotic technology. (vattikutifoundation.com)
Biopsy1
- Attendees will apply this knowledge to decide between active surveillance and surgical intervention and when to utilize renal tumor biopsy. (auanet.org)
Favorable1
- Even in elderly individuals, if good functional status, sufficiently fit to surgery, and favorable tumor characteristics, they should be encouraged to perform PN. (biomedcentral.com)
Parenchyma3
- Tumor pseudo-capsule (PC), and parenchyma within 2 cm from tumor margin, were pathologically assessed. (biomedcentral.com)
- The parenchyma beyond PC or tumor margin was divided into 20 subsections of 1 mm in width. (biomedcentral.com)
- A limited number of studies have focused on the comprehensive pathological analysis of non-neoplastic parenchyma in renal cell carcinoma (RCC), which includes the peritumoral parenchyma and the more distant parenchyma from the tumor. (biomedcentral.com)
Intraoperative ultrasound1
- These tumors are challenging, needs expertise and use of intraoperative ultrasound. (vattikutifoundation.com)
Papillary1
- All tumors were confirmed RCCs (clear cell vs. papillary vs. chromophobe were 83% vs. 5.7% vs. 11.3%, respectively), with a mean size of 5.6 cm. (biomedcentral.com)
Surgical3
- The 3D model was used to plan the surgical strategy and guide the procedure during the tumour approach . (modelosmedicos.com)
- New surgical techniques for stopping bleeding and safely closing the renal cortex after removal of multiple renal tumors will be discussed. (auanet.org)
- Surgical approaches for re-operative surgery in patients with recurrent, multiple renal tumors will be reviewed. (auanet.org)
Approach1
- Relation of the tumor to the renal vasculature decides the approach. (ainuindia.org)
Completely2
- Introduction: Completely endophytic tumors are tumors not visible on renal surface. (vattikutifoundation.com)
- Conclusion: Completely endophytic tumors are complex, requires preoperative detailed study of CT-angiography films, imperative use of ultrasonography, and need of bloodless field. (vattikutifoundation.com)
Cases1
- Twenty cases of endophyte tumors were operated during this time period. (vattikutifoundation.com)
Large1
- Employ techniques for management of large and/or locally advanced tumors including management of renal vein or inferior vena cava invasion and the use of lymphadenectomy. (auanet.org)
Initial1
- Furthermore, both CD8+ to CD3+ and CD8+ to CD11b+ T-lymphocyte ratios in subcutaneous RenCa tumors were significantly higher in the simultaneous and initial ICI administration, but not the initial axitinib administration, compared to the control. (bvsalud.org)