Off-Clamp versus On-Clamp Robotic Partial Nephrectomy: A Multicenter Match-Paired Case-Control Study.
Urol Int
; 99(3): 272-276, 2017.
Article
em En
| MEDLINE
| ID: mdl-28380483
ABSTRACT
INTRODUCTION:
The aim of this study was to compare the outcomes of on-clamp and off-clamp robotic partial nephrectomy (RPN). MATERIALS ANDMETHODS:
The charts of all patients who underwent an RPN at 8 institutions between 2010 and 2014 were retrospectively reviewed. The patients who underwent an off-clamp RPN were matched to on-clamp RPN in a 1-4 fashion according to the following variables RENAL score, tumor size and surgeon's experience. Pre-, intra-, and postoperative data were compared between both groups.RESULTS:
Among 525 RPN, 26 were performed off-clamp (5%). They were matched to 104 on-clamp RPN. The complications rate (15.5 vs. 7.7%, p = 0.53), major complications rate (4.9 vs. 3.9%; p = 0.82), and transfusions rate (0 vs. 4.9%; p = 0.58) did not differ significantly between the clamped and unclamped groups. Conversely, estimated blood loss was higher in the off-clamp group (266.4 vs. 284.6 mL, p = 0.048) and so was the rate of conversion to radical nephrectomy (0 vs. 7.7%, p = 0.04). Postoperative preservation of renal function was comparable in both groups.CONCLUSION:
Off-clamp RPN is feasible for a small subgroup of renal tumors without increased risk of postoperative complications but at the cost of higher estimated blood loss and increased risk of conversion to radical nephrectomy.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Isquemia Quente
/
Procedimentos Cirúrgicos Robóticos
/
Neoplasias Renais
/
Nefrectomia
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Humans
País/Região como assunto:
Europa
Idioma:
En
Revista:
Urol Int
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
França