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Comparison of Minimally Invasive Surgical Approaches in the Management of Small Renal Masses at a Safety Net Hospital

Received: 21 April 2021    Accepted: 3 May 2021    Published: 14 May 2021
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Abstract

Partial nephrectomy can be performed with traditional straight laparoscopy (SL), hand- assisted laparoscopic (HAL) and robotic-assisted laparoscopic (RAL) techniques. The purpose of this study is to analyze trends in surgical technique and compare the intra- and post-operative outcomes at a safety net hospital. We performed a single-institution retrospective review of intra- and post-operative outcomes in partial nephrectomy cases between 2012 and 2018. We analyzed the impact of patient demographics, tumor characteristics, and RENAL nephrometry score on surgical outcomes and post-operative complications among the three surgical approaches to partial nephrectomy. Of the 164 partial nephrectomies, 36 were SL, 65 HAL, and 63 RAL. Most SL was performed in the early years, whereas most RAL was performed in the later years, and HA was evenly distributed throughout the years. There was no difference in demographics, intra-operative complications, estimated blood loss, or positive margin rates between SL, HAL, and RAL. HAL partial nephrectomies had a higher RENAL nephrometry score and had statistically significant less warm ischemia and operative times when compared to RAL. HAL is a worthwhile technique in larger and more complex masses and especially in settings where robotic surgery is unable to be performed.

Published in International Journal of Clinical Urology (Volume 5, Issue 1)
DOI 10.11648/j.ijcu.20210501.18
Page(s) 38-42
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Partial Nephrectomy, Laparoscopy, Robotics, Minimally Invasive Surgery, Renal Cell Carcinoma

References
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[3] Poppel H, Pozzo L, Albrecht W, et al. A Prospective, Randomised EORTC Intergroup Phase 3 Study Comparing the Oncologic Outcome of Elective Nephron-Sparing Surgery and Radical Nephrectomy for Low-Stage Renal Cell Carcinoma. Eur Urol. 2011; 59: 543-552.
[4] Pierorazio P, Johnson M, Patel H, et al. Management of Renal Masses and Localized Renal Cancer: Systematic Review and Meta-Analysis. J Urol. 2016; 162: 989-999.
[5] Permpongkosol S, Bagga HS, Romero FR, et al. Trends in the operative management of renal tumours over a 14-year period. BJU Int. 2006; 98: 751-755.
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Cite This Article
  • APA Style

    Liz Wang, Michel Apoj, Remington Lim, Shaun Wason, Mark Katz, et al. (2021). Comparison of Minimally Invasive Surgical Approaches in the Management of Small Renal Masses at a Safety Net Hospital. International Journal of Clinical Urology, 5(1), 38-42. https://doi.org/10.11648/j.ijcu.20210501.18

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    ACS Style

    Liz Wang; Michel Apoj; Remington Lim; Shaun Wason; Mark Katz, et al. Comparison of Minimally Invasive Surgical Approaches in the Management of Small Renal Masses at a Safety Net Hospital. Int. J. Clin. Urol. 2021, 5(1), 38-42. doi: 10.11648/j.ijcu.20210501.18

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    AMA Style

    Liz Wang, Michel Apoj, Remington Lim, Shaun Wason, Mark Katz, et al. Comparison of Minimally Invasive Surgical Approaches in the Management of Small Renal Masses at a Safety Net Hospital. Int J Clin Urol. 2021;5(1):38-42. doi: 10.11648/j.ijcu.20210501.18

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  • @article{10.11648/j.ijcu.20210501.18,
      author = {Liz Wang and Michel Apoj and Remington Lim and Shaun Wason and Mark Katz and David Wang},
      title = {Comparison of Minimally Invasive Surgical Approaches in the Management of Small Renal Masses at a Safety Net Hospital},
      journal = {International Journal of Clinical Urology},
      volume = {5},
      number = {1},
      pages = {38-42},
      doi = {10.11648/j.ijcu.20210501.18},
      url = {https://doi.org/10.11648/j.ijcu.20210501.18},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcu.20210501.18},
      abstract = {Partial nephrectomy can be performed with traditional straight laparoscopy (SL), hand- assisted laparoscopic (HAL) and robotic-assisted laparoscopic (RAL) techniques. The purpose of this study is to analyze trends in surgical technique and compare the intra- and post-operative outcomes at a safety net hospital. We performed a single-institution retrospective review of intra- and post-operative outcomes in partial nephrectomy cases between 2012 and 2018. We analyzed the impact of patient demographics, tumor characteristics, and RENAL nephrometry score on surgical outcomes and post-operative complications among the three surgical approaches to partial nephrectomy. Of the 164 partial nephrectomies, 36 were SL, 65 HAL, and 63 RAL. Most SL was performed in the early years, whereas most RAL was performed in the later years, and HA was evenly distributed throughout the years. There was no difference in demographics, intra-operative complications, estimated blood loss, or positive margin rates between SL, HAL, and RAL. HAL partial nephrectomies had a higher RENAL nephrometry score and had statistically significant less warm ischemia and operative times when compared to RAL. HAL is a worthwhile technique in larger and more complex masses and especially in settings where robotic surgery is unable to be performed.},
     year = {2021}
    }
    

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    AU  - Liz Wang
    AU  - Michel Apoj
    AU  - Remington Lim
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    T2  - International Journal of Clinical Urology
    JF  - International Journal of Clinical Urology
    JO  - International Journal of Clinical Urology
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    UR  - https://doi.org/10.11648/j.ijcu.20210501.18
    AB  - Partial nephrectomy can be performed with traditional straight laparoscopy (SL), hand- assisted laparoscopic (HAL) and robotic-assisted laparoscopic (RAL) techniques. The purpose of this study is to analyze trends in surgical technique and compare the intra- and post-operative outcomes at a safety net hospital. We performed a single-institution retrospective review of intra- and post-operative outcomes in partial nephrectomy cases between 2012 and 2018. We analyzed the impact of patient demographics, tumor characteristics, and RENAL nephrometry score on surgical outcomes and post-operative complications among the three surgical approaches to partial nephrectomy. Of the 164 partial nephrectomies, 36 were SL, 65 HAL, and 63 RAL. Most SL was performed in the early years, whereas most RAL was performed in the later years, and HA was evenly distributed throughout the years. There was no difference in demographics, intra-operative complications, estimated blood loss, or positive margin rates between SL, HAL, and RAL. HAL partial nephrectomies had a higher RENAL nephrometry score and had statistically significant less warm ischemia and operative times when compared to RAL. HAL is a worthwhile technique in larger and more complex masses and especially in settings where robotic surgery is unable to be performed.
    VL  - 5
    IS  - 1
    ER  - 

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Author Information
  • Department of Urology, Boston Medical Center, Boston University School of Medicine, Boston, USA

  • Department of Urology, Boston Medical Center, Boston University School of Medicine, Boston, USA

  • Department of Urology, Boston Medical Center, Boston University School of Medicine, Boston, USA

  • Department of Urology, Boston Medical Center, Boston University School of Medicine, Boston, USA

  • Department of Urology, Boston Medical Center, Boston University School of Medicine, Boston, USA

  • Department of Urology, Boston Medical Center, Boston University School of Medicine, Boston, USA

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