TORNA ALL’ELENCO

Surgical management of T2 renal tumors: Perioperative and functional outcomes of laparoscopic partial nephrectomy in European Urology, Supplements

2018
AOU San Luigi di Orbassano

Tipo pubblicazione

Conference Abstract

Autori/Collaboratori (13)Vedi tutti...

Scarpa RM

Fiori C

Manfredi M


et alii...

Abstract

Introduction & Objectives: A nephron-sparing approach is recommended by the guidelines when embarking in the surgical management of T1 renal masses. But a paucity of data is available in Literature about partial nephrectomy (PN) for clinically-staged T2 (cT2) renal masses. The aim of the study was to evaluate perioperative, pathological and early functional outcomes of laparoscopic PN for cT2 renal tumors. Materials & Methods: All patients who underwent Laparoscopic PN between 06/2000 and 12/2016 were included in the analysis and retrospectively evaluated. All the surgical procedures were performed by the same surgeon. Demographics variables (gender, age, BMI and comorbidities, as classified by Charlson's Comorbidity Index) were evaluated; preoperative variables (side, size and surgical complexity of the lesion as classified by PADUA score), perioperative variables (blood losses, intra- and post-operative complications as classified by Clavien system) and hospital stay were considered. Concerning pathological variables, histology and positive surgical margins rate at final pathology were analyzed. Functional outcomes like serum creatinine (SCr) and estimated glomerular filtration rate (eGFR) were evaluated preoperatively and at discharge. Results: 21 patients were included in the present study: 14 of them (66.6%) were males, median age was 56 yrs (IQR 54-60), mean BMI was 24.4+3.34 and median CCI 2 (IQR 1-3). Lesions were right-sided in 42.8% (9/21), with a mean size of 76.5+11.1 mm and a median PADUA score of 10 (IQR 9-11). Two patients (9.5%) had solitary kidney. Concerning perioperative variables mean operative time was 131.4+40.9 min, with mean blood losses of 259.5+212.1 ml. Mean ischemia time was 22.4+13.1 min, 19% (4/21) of the procedures were performed without clamping of renal artery. Intraoperative complications rate was 9.5% (2/21). The rate of postoperative complications was 23.8% (5/21), with Clavien > 3 complications recorded in 1 patients only.

Keywords

adult; bleeding; body mass; clinical article; comorbidity; complication; conference abstract; controlled study; creatinine blood level; estimated glomerular filtration rate; female; gender; histology; histopathology; hospitalization; human; human tissue; ischemia; kidney artery; kidney tumor; male; middle aged; partial nephrectomy; peroperative complication; postoperative complication; preoperative evaluation; radical nephrectomy; retrospective study; sample size; solitary kidney; surgeon; surgery; surgical margin; surgical technique;