Robot-assisted Partial Nephrectomy for Hilar Tumors: Perioperative Outcomes
Objective To compare perioperative outcomes of robot-assisted partial nephrectomy (RAPN) for hilar vs nonhilar tumors. Materials and Methods The study retrospectively reviewed 364 patients with available computed tomography scans undergoing RAPN. Demographic data and perioperative outcomes results w...
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| Veröffentlicht in: | Urology (Ridgewood, N.J.) N.J.), 2013-06, Vol.81 (6), p.1246-1252 |
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| creator | Eyraud, Rémi Long, Jean-Alexandre Snow-Lisy, Devon Autorino, Riccardo Hillyer, Shahab Klink, Joseph Rizkala, Emad Stein, Robert J Kaouk, Jihad H Haber, Georges-Pascal |
| description | Objective To compare perioperative outcomes of robot-assisted partial nephrectomy (RAPN) for hilar vs nonhilar tumors. Materials and Methods The study retrospectively reviewed 364 patients with available computed tomography scans undergoing RAPN. Demographic data and perioperative outcomes results were compared between the hilar (group 1, n = 70) and nonhilar tumors (group 2, n = 294). Multivariate analysis was used to identify predictors of warm ischemia time (WIT), estimated blood loss (EBL), major perioperative complications, and postoperative renal function. Results There were no differences with respect to demographic variables. Hilar tumors had higher RENAL (radius, exophytic/endophytic properties of the tumor, nearness of tumor deepest portion to the collecting system or sinus, anterior/posterior descriptor and the location relative to polar lines) scores ( P |
| doi_str_mv | 10.1016/j.urology.2012.10.072 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1364711359</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S0090429512015646</els_id><sourcerecordid>1364711359</sourcerecordid><originalsourceid>FETCH-LOGICAL-c516t-82295a99c98e8f25881b419ba451dfb244f42db7e37446ecc26d017fcbb9cc303</originalsourceid><addsrcrecordid>eNqFkU1r3DAQhkVoaTZpf0KLL4VevJFkSbZ6aAihaUJDE_JxFrI8TrSxrY3GDuy_r8xuWuilp4HhmZmXZwj5yOiSUaaOVssphi48bJacMp56S1ryPbJgkpe51lq-IQtKNc0F13KfHCCuKKVKqfId2eeFokwItSA_b0Idxtwiehyhya5tHL3tsl-wfozgxtBvsjbE7Nx3NmZ3Ux8ifs2uIfqwhmhH_wLZ1TS60AO-J29b2yF82NVDcn_2_e70PL-8-nFxenKZO8nUmFc8JbJaO11B1XJZVawWTNdWSNa0NReiFbypSyjKFBGc46qhrGxdXWvnClocki_bvesYnifA0fQeHXSdHSBMaFihRMlYIXVC5RZ1MSBGaM06-t7GjWHUzB7Nyuw8mtnj3E4e09yn3Ymp7qH5M_UqLgGfd4BFZ7s22sF5_Mul6FVRzQGOtxwkIS8eokHnYXDQ-FmvaYL_b5Rv_2xwnR98OvoEG8BVmOKQbBtmkBtqbuenzz9naYlUKepvTC6o0g</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1364711359</pqid></control><display><type>article</type><title>Robot-assisted Partial Nephrectomy for Hilar Tumors: Perioperative Outcomes</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Eyraud, Rémi ; Long, Jean-Alexandre ; Snow-Lisy, Devon ; Autorino, Riccardo ; Hillyer, Shahab ; Klink, Joseph ; Rizkala, Emad ; Stein, Robert J ; Kaouk, Jihad H ; Haber, Georges-Pascal</creator><creatorcontrib>Eyraud, Rémi ; Long, Jean-Alexandre ; Snow-Lisy, Devon ; Autorino, Riccardo ; Hillyer, Shahab ; Klink, Joseph ; Rizkala, Emad ; Stein, Robert J ; Kaouk, Jihad H ; Haber, Georges-Pascal</creatorcontrib><description>Objective To compare perioperative outcomes of robot-assisted partial nephrectomy (RAPN) for hilar vs nonhilar tumors. Materials and Methods The study retrospectively reviewed 364 patients with available computed tomography scans undergoing RAPN. Demographic data and perioperative outcomes results were compared between the hilar (group 1, n = 70) and nonhilar tumors (group 2, n = 294). Multivariate analysis was used to identify predictors of warm ischemia time (WIT), estimated blood loss (EBL), major perioperative complications, and postoperative renal function. Results There were no differences with respect to demographic variables. Hilar tumors had higher RENAL (radius, exophytic/endophytic properties of the tumor, nearness of tumor deepest portion to the collecting system or sinus, anterior/posterior descriptor and the location relative to polar lines) scores ( P <.001) and were larger (3.9 vs 2.6 cm, P <.001). Surgeries for hilar tumors were associated with greater operative time (210 vs 180 minutes, P <.001), longer WIT (27 vs 17 minutes, P <.001), and increased EBL (250 vs 200 mL, P = .04). No differences were noted in transfusion rate, length of stay, complications (overall and major) and positive margins. Postoperative estimated glomerular filtration rate showed no significant difference between hilar vs nonhilar patients on postoperative day 3 (70.12 vs 74.71 mL/min/1.73 m2 , P = .31) or at last follow-up (72.62 vs 75.78 mL/min/1.73 m2 , P = .40), respectively. Multivariate analysis found hilar location was independently associated with increased WIT without significant changes in EBL, major complications, or postoperative renal function. Conclusion RAPN represents a safe and effective procedure for hilar tumors. Hilar location for patients undergoing RAPN in a high-volume institution seems not be associated with an increased risk of transfusions, major complications, or decline of early postoperative renal function.</description><identifier>ISSN: 0090-4295</identifier><identifier>EISSN: 1527-9995</identifier><identifier>DOI: 10.1016/j.urology.2012.10.072</identifier><identifier>PMID: 23601446</identifier><identifier>CODEN: URGYAZ</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Aged ; Biological and medical sciences ; Blood Loss, Surgical ; Female ; Glomerular Filtration Rate ; Humans ; Kidney - physiopathology ; Kidney Neoplasms - diagnostic imaging ; Kidney Neoplasms - pathology ; Kidney Neoplasms - surgery ; Laparoscopy - adverse effects ; Logistic Models ; Male ; Medical sciences ; Middle Aged ; Multivariate Analysis ; Nephrectomy - adverse effects ; Nephrology. Urinary tract diseases ; Operative Time ; Organ Sparing Treatments ; Postoperative Period ; Radiography ; Retrospective Studies ; Robotics ; Urology ; Warm Ischemia</subject><ispartof>Urology (Ridgewood, N.J.), 2013-06, Vol.81 (6), p.1246-1252</ispartof><rights>Elsevier Inc.</rights><rights>2013 Elsevier Inc.</rights><rights>2014 INIST-CNRS</rights><rights>Copyright © 2013 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c516t-82295a99c98e8f25881b419ba451dfb244f42db7e37446ecc26d017fcbb9cc303</citedby><cites>FETCH-LOGICAL-c516t-82295a99c98e8f25881b419ba451dfb244f42db7e37446ecc26d017fcbb9cc303</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0090429512015646$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=27448389$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23601446$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Eyraud, Rémi</creatorcontrib><creatorcontrib>Long, Jean-Alexandre</creatorcontrib><creatorcontrib>Snow-Lisy, Devon</creatorcontrib><creatorcontrib>Autorino, Riccardo</creatorcontrib><creatorcontrib>Hillyer, Shahab</creatorcontrib><creatorcontrib>Klink, Joseph</creatorcontrib><creatorcontrib>Rizkala, Emad</creatorcontrib><creatorcontrib>Stein, Robert J</creatorcontrib><creatorcontrib>Kaouk, Jihad H</creatorcontrib><creatorcontrib>Haber, Georges-Pascal</creatorcontrib><title>Robot-assisted Partial Nephrectomy for Hilar Tumors: Perioperative Outcomes</title><title>Urology (Ridgewood, N.J.)</title><addtitle>Urology</addtitle><description>Objective To compare perioperative outcomes of robot-assisted partial nephrectomy (RAPN) for hilar vs nonhilar tumors. Materials and Methods The study retrospectively reviewed 364 patients with available computed tomography scans undergoing RAPN. Demographic data and perioperative outcomes results were compared between the hilar (group 1, n = 70) and nonhilar tumors (group 2, n = 294). Multivariate analysis was used to identify predictors of warm ischemia time (WIT), estimated blood loss (EBL), major perioperative complications, and postoperative renal function. Results There were no differences with respect to demographic variables. Hilar tumors had higher RENAL (radius, exophytic/endophytic properties of the tumor, nearness of tumor deepest portion to the collecting system or sinus, anterior/posterior descriptor and the location relative to polar lines) scores ( P <.001) and were larger (3.9 vs 2.6 cm, P <.001). Surgeries for hilar tumors were associated with greater operative time (210 vs 180 minutes, P <.001), longer WIT (27 vs 17 minutes, P <.001), and increased EBL (250 vs 200 mL, P = .04). No differences were noted in transfusion rate, length of stay, complications (overall and major) and positive margins. Postoperative estimated glomerular filtration rate showed no significant difference between hilar vs nonhilar patients on postoperative day 3 (70.12 vs 74.71 mL/min/1.73 m2 , P = .31) or at last follow-up (72.62 vs 75.78 mL/min/1.73 m2 , P = .40), respectively. Multivariate analysis found hilar location was independently associated with increased WIT without significant changes in EBL, major complications, or postoperative renal function. Conclusion RAPN represents a safe and effective procedure for hilar tumors. Hilar location for patients undergoing RAPN in a high-volume institution seems not be associated with an increased risk of transfusions, major complications, or decline of early postoperative renal function.</description><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Blood Loss, Surgical</subject><subject>Female</subject><subject>Glomerular Filtration Rate</subject><subject>Humans</subject><subject>Kidney - physiopathology</subject><subject>Kidney Neoplasms - diagnostic imaging</subject><subject>Kidney Neoplasms - pathology</subject><subject>Kidney Neoplasms - surgery</subject><subject>Laparoscopy - adverse effects</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Nephrectomy - adverse effects</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Operative Time</subject><subject>Organ Sparing Treatments</subject><subject>Postoperative Period</subject><subject>Radiography</subject><subject>Retrospective Studies</subject><subject>Robotics</subject><subject>Urology</subject><subject>Warm Ischemia</subject><issn>0090-4295</issn><issn>1527-9995</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU1r3DAQhkVoaTZpf0KLL4VevJFkSbZ6aAihaUJDE_JxFrI8TrSxrY3GDuy_r8xuWuilp4HhmZmXZwj5yOiSUaaOVssphi48bJacMp56S1ryPbJgkpe51lq-IQtKNc0F13KfHCCuKKVKqfId2eeFokwItSA_b0Idxtwiehyhya5tHL3tsl-wfozgxtBvsjbE7Nx3NmZ3Ux8ifs2uIfqwhmhH_wLZ1TS60AO-J29b2yF82NVDcn_2_e70PL-8-nFxenKZO8nUmFc8JbJaO11B1XJZVawWTNdWSNa0NReiFbypSyjKFBGc46qhrGxdXWvnClocki_bvesYnifA0fQeHXSdHSBMaFihRMlYIXVC5RZ1MSBGaM06-t7GjWHUzB7Nyuw8mtnj3E4e09yn3Ymp7qH5M_UqLgGfd4BFZ7s22sF5_Mul6FVRzQGOtxwkIS8eokHnYXDQ-FmvaYL_b5Rv_2xwnR98OvoEG8BVmOKQbBtmkBtqbuenzz9naYlUKepvTC6o0g</recordid><startdate>20130601</startdate><enddate>20130601</enddate><creator>Eyraud, Rémi</creator><creator>Long, Jean-Alexandre</creator><creator>Snow-Lisy, Devon</creator><creator>Autorino, Riccardo</creator><creator>Hillyer, Shahab</creator><creator>Klink, Joseph</creator><creator>Rizkala, Emad</creator><creator>Stein, Robert J</creator><creator>Kaouk, Jihad H</creator><creator>Haber, Georges-Pascal</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20130601</creationdate><title>Robot-assisted Partial Nephrectomy for Hilar Tumors: Perioperative Outcomes</title><author>Eyraud, Rémi ; Long, Jean-Alexandre ; Snow-Lisy, Devon ; Autorino, Riccardo ; Hillyer, Shahab ; Klink, Joseph ; Rizkala, Emad ; Stein, Robert J ; Kaouk, Jihad H ; Haber, Georges-Pascal</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c516t-82295a99c98e8f25881b419ba451dfb244f42db7e37446ecc26d017fcbb9cc303</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Blood Loss, Surgical</topic><topic>Female</topic><topic>Glomerular Filtration Rate</topic><topic>Humans</topic><topic>Kidney - physiopathology</topic><topic>Kidney Neoplasms - diagnostic imaging</topic><topic>Kidney Neoplasms - pathology</topic><topic>Kidney Neoplasms - surgery</topic><topic>Laparoscopy - adverse effects</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Nephrectomy - adverse effects</topic><topic>Nephrology. Urinary tract diseases</topic><topic>Operative Time</topic><topic>Organ Sparing Treatments</topic><topic>Postoperative Period</topic><topic>Radiography</topic><topic>Retrospective Studies</topic><topic>Robotics</topic><topic>Urology</topic><topic>Warm Ischemia</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Eyraud, Rémi</creatorcontrib><creatorcontrib>Long, Jean-Alexandre</creatorcontrib><creatorcontrib>Snow-Lisy, Devon</creatorcontrib><creatorcontrib>Autorino, Riccardo</creatorcontrib><creatorcontrib>Hillyer, Shahab</creatorcontrib><creatorcontrib>Klink, Joseph</creatorcontrib><creatorcontrib>Rizkala, Emad</creatorcontrib><creatorcontrib>Stein, Robert J</creatorcontrib><creatorcontrib>Kaouk, Jihad H</creatorcontrib><creatorcontrib>Haber, Georges-Pascal</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Urology (Ridgewood, N.J.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Eyraud, Rémi</au><au>Long, Jean-Alexandre</au><au>Snow-Lisy, Devon</au><au>Autorino, Riccardo</au><au>Hillyer, Shahab</au><au>Klink, Joseph</au><au>Rizkala, Emad</au><au>Stein, Robert J</au><au>Kaouk, Jihad H</au><au>Haber, Georges-Pascal</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Robot-assisted Partial Nephrectomy for Hilar Tumors: Perioperative Outcomes</atitle><jtitle>Urology (Ridgewood, N.J.)</jtitle><addtitle>Urology</addtitle><date>2013-06-01</date><risdate>2013</risdate><volume>81</volume><issue>6</issue><spage>1246</spage><epage>1252</epage><pages>1246-1252</pages><issn>0090-4295</issn><eissn>1527-9995</eissn><coden>URGYAZ</coden><abstract>Objective To compare perioperative outcomes of robot-assisted partial nephrectomy (RAPN) for hilar vs nonhilar tumors. Materials and Methods The study retrospectively reviewed 364 patients with available computed tomography scans undergoing RAPN. Demographic data and perioperative outcomes results were compared between the hilar (group 1, n = 70) and nonhilar tumors (group 2, n = 294). Multivariate analysis was used to identify predictors of warm ischemia time (WIT), estimated blood loss (EBL), major perioperative complications, and postoperative renal function. Results There were no differences with respect to demographic variables. Hilar tumors had higher RENAL (radius, exophytic/endophytic properties of the tumor, nearness of tumor deepest portion to the collecting system or sinus, anterior/posterior descriptor and the location relative to polar lines) scores ( P <.001) and were larger (3.9 vs 2.6 cm, P <.001). Surgeries for hilar tumors were associated with greater operative time (210 vs 180 minutes, P <.001), longer WIT (27 vs 17 minutes, P <.001), and increased EBL (250 vs 200 mL, P = .04). No differences were noted in transfusion rate, length of stay, complications (overall and major) and positive margins. Postoperative estimated glomerular filtration rate showed no significant difference between hilar vs nonhilar patients on postoperative day 3 (70.12 vs 74.71 mL/min/1.73 m2 , P = .31) or at last follow-up (72.62 vs 75.78 mL/min/1.73 m2 , P = .40), respectively. Multivariate analysis found hilar location was independently associated with increased WIT without significant changes in EBL, major complications, or postoperative renal function. Conclusion RAPN represents a safe and effective procedure for hilar tumors. Hilar location for patients undergoing RAPN in a high-volume institution seems not be associated with an increased risk of transfusions, major complications, or decline of early postoperative renal function.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>23601446</pmid><doi>10.1016/j.urology.2012.10.072</doi><tpages>7</tpages></addata></record> |
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| subjects | Aged Biological and medical sciences Blood Loss, Surgical Female Glomerular Filtration Rate Humans Kidney - physiopathology Kidney Neoplasms - diagnostic imaging Kidney Neoplasms - pathology Kidney Neoplasms - surgery Laparoscopy - adverse effects Logistic Models Male Medical sciences Middle Aged Multivariate Analysis Nephrectomy - adverse effects Nephrology. Urinary tract diseases Operative Time Organ Sparing Treatments Postoperative Period Radiography Retrospective Studies Robotics Urology Warm Ischemia |
| title | Robot-assisted Partial Nephrectomy for Hilar Tumors: Perioperative Outcomes |
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