Factors influencing warm ischemia time in robot-assisted partial nephrectomy change depending on the surgeon's experience.
Kidney
Oncology
RENAL score
Robotic surgery
Journal
World journal of surgical oncology
ISSN: 1477-7819
Titre abrégé: World J Surg Oncol
Pays: England
ID NLM: 101170544
Informations de publication
Date de publication:
15 Jun 2022
15 Jun 2022
Historique:
received:
28
01
2022
accepted:
02
06
2022
entrez:
14
6
2022
pubmed:
15
6
2022
medline:
18
6
2022
Statut:
epublish
Résumé
Warm ischemia time (WIT) is a primary concern for robot-assisted laparoscopic partial nephrectomy (RALPN) patients because longer WIT is significantly associated with postoperative deteriorating kidney function. Tumor complexity, determined by the RENAL nephrometry score (RENAL score), can help predict surgical outcomes, but it is unclear what RENAL score and clinical factors affect WIT. This study explored the clinical factors predicting long WIT in experienced surgeon to RALPN. In our institute, 174 RALPNs were performed between November 2013 and February 2021, of which 114 were performed by a single surgeon and included in this study. Clinical staging and the total RENAL score were determined based on preoperative CT scans. The cases were divided into three groups based on experience: period 1: 1-38, period 2: 39-76, and period 3: 77-114. The clinical factors associated with longer WIT were analyzed per period. The overall median tumor diameter was 32 mm, and one patient had a positive surgical margin, but there were no cancer-related deaths. In total, there were 18 complications (15.8%). Periods 2 and 3 had larger tumor diameters (p < 0.01) and worse preoperative kidney function (p = 0.029) than period 1. A RENAL L-component score of 3 was associated with longer WIT in period 3 (odds ratio: 3.900; 95% confidence interval: 1.004-15.276; p = 0.044), but the tumor diameter and the total RENAL score were not. A large tumor in the central lesion indicated by the RENAL L-component score was associated with increased WIT in RALPN.
Identifiants
pubmed: 35701769
doi: 10.1186/s12957-022-02669-0
pii: 10.1186/s12957-022-02669-0
pmc: PMC9199197
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
202Informations de copyright
© 2022. The Author(s).
Références
Eur Urol. 2014 Sep;66(3):542-9
pubmed: 24857539
Lancet. 2010 Jun 12;375(9731):2073-81
pubmed: 20483451
JSLS. 2018 Jan-Mar;22(1):
pubmed: 29472757
J Endourol. 2020 May;34(5):594-599
pubmed: 32164450
J Endourol. 2011 Dec;25(12):1921-4
pubmed: 21905850
World J Surg Oncol. 2020 Jun 30;18(1):148
pubmed: 32605570
Ann Surg Oncol. 2021 Feb;28(2):1254-1261
pubmed: 32710272
Eur Urol Focus. 2019 Jul;5(4):636-641
pubmed: 29111154
Can Urol Assoc J. 2017 Jun;11(6):199-203
pubmed: 28652879
Asian J Endosc Surg. 2017 Nov;10(4):372-381
pubmed: 28905493
Cancer Med. 2020 Jan;9(2):586-594
pubmed: 31788986
Asian J Endosc Surg. 2020 Jan;13(1):59-64
pubmed: 30689309
J Laparoendosc Adv Surg Tech A. 2019 Jan;29(1):45-50
pubmed: 30300074
J Urol. 2013 Jan;189(1):36-42
pubmed: 23164381
J Endourol. 2012 May;26(5):509-14
pubmed: 21823983
Cent European J Urol. 2017;70(3):232-237
pubmed: 29104784
World J Urol. 2020 May;38(5):1235-1242
pubmed: 31346763
Eur Urol. 2016 Jun;69(6):1149-54
pubmed: 26719014
Eur Urol Focus. 2020 May 15;6(3):490-504
pubmed: 31776071
JSLS. 2017 Jan-Mar;21(1):
pubmed: 28352149
Surg Clin North Am. 2020 Apr;100(2):361-378
pubmed: 32169184
Int Braz J Urol. 2018 Jan-Feb;44(1):199
pubmed: 28379673
World J Surg Oncol. 2021 Feb 4;19(1):40
pubmed: 33541337
Ann Surg. 2009 Aug;250(2):187-96
pubmed: 19638912
World J Urol. 2014 Feb;32(1):131-6
pubmed: 23504074
Urology. 2012 May;79(5):1052-6
pubmed: 22546382
Eur Urol. 2015 May;67(5):913-24
pubmed: 25616710
Urology. 2013 Jun;81(6):1246-51
pubmed: 23601446
Eur Urol. 2015 Jul;68(1):61-74
pubmed: 25703575