[Minimally invasive vs. open partial nephrectomy : Perioperative success and complication rates]. / Minimal-invasive vs. offene Nierenteilresektionen : Perioperative Erfolgs- und Komplikationsraten.
Urologe A
; 57(7): 821-827, 2018 Jul.
Article
em De
| MEDLINE
| ID: mdl-29691592
ABSTRACT
BACKGROUND:
Solid renal masses are increasingly treated with nephron-sparing surgery. As in other uro-oncological surgical techniques, minimally invasive and robotic-assisted techniques are becoming increasingly popular.OBJECTIVES:
The perioperative results from minimally invasive nephron-sparing surgery versus open surgery were retrospectively compared. MATERIALS ANDMETHODS:
In our single center retrospective study, all patients who underwent nephron-sparing tumor excision between 2006 and 2016 were divided into two groups (group Oâ¯= open approach and group Mâ¯= minimally invasive approach). The (pre-)operative data, complications, and change in renal function were compared. Trifecta criteria (R0, no perioperative complications, ischemia ≤25â¯min) were used to determine success rates.RESULTS:
Of 329 patients, 310 were included for analysis (group O 123, group M 187). Patients in group O had significantly worse ASA score but comparable Charlson Index and significantly more pT3/4 tumors but equal PADUA-score when compared with group M. Otherwise, preoperative patient and tumor characteristics were comparable. Patients in group M had significantly shorter hospital stays (pâ¯< 0.001) and lower transfusion rates (pâ¯< 0.05). Trifecta criteria were more frequently met in group M than in O (M 66.8% vs. 0 49.6%; pâ¯< 0.001). Both major and minor complications were lower in group M (major 10.7% vs 17.1%; minor 13.9% vs. 26.0%; pâ¯< 0.05). Preservation of renal function was comparable in both groups. R0 rates did not differ significantly between groups (M 97.8% vs O 97.5%). Surgical procedure times were significantly longer in group M (pâ¯< 0.001; mean 30â¯min).CONCLUSIONS:
Minimally invasive, robotic assisted partial nephrectomy also proved to be successful in complex cases. In all aspects studied, the minimally invasive approach was shown to be at least equivalent to the open approach.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
/
Carcinoma de Células Renais
/
Procedimentos Cirúrgicos Minimamente Invasivos
/
Tratamentos com Preservação do Órgão
/
Neoplasias Renais
/
Nefrectomia
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Female
/
Humans
/
Male
País/Região como assunto:
Europa
Idioma:
De
Ano de publicação:
2018
Tipo de documento:
Article