‘Trifecta’ outcomes of robot-assisted partial nephrectomy: Results of the ‘low volume’ surgeon

Detalhes bibliográficos
Autor(a) principal: Basatac,Cem
Data de Publicação: 2020
Outros Autores: Akpinar,Haluk
Tipo de documento: Artigo
Idioma: eng
Título da fonte: International Braz J Urol (Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382020000600943
Resumo: ABSTRACT Objective There is limited data regarding surgeon volume and partial nephrectomy outcomes. The aim of this study is to report trifecta outcomes of robot-assisted partial nephrectomy (RAPN) performed by the low volume surgeon. Materials and Methods Thirty-nine patients with clinical T1-2 renal tumors who underwent RAPN between 2012 and 2018 were included in this study. Trifecta was defined as negative surgical margins, warm ischemia time ≤20 minutes, and no operative complications. Patient demographics, R.E.N.A.L. nephrometry score, operation time, estimated blood loss, warm ischemia time, length of hospital stay, renal functions, and oncological outcomes were analyzed retrospectively. Complications were graded based on the modified Clavien-Dindo classification system. Results The median R.E.N.A.L. nephrometry score was 6 (4-10). RAPN was successfully performed in all but one patient. The median operation time was 180 (90-240) minutes. Warm ischemia was performed only by segmental renal artery control in 35 and, by main renal artery control in three patients. The off-clamp technique was used in two patients. The median warm ischemia time was 16 (0-31) minutes. Seven patients had a warm ischemia time of longer than 20 minutes. Three patients had postoperative complications. The surgical margin was positive in one patient. As a result, the trifecta was achieved in 30 of the 39 patients (77%). Conclusion RAPN is a safe and effective minimally invasive alternative in the treatment of renal masses. The present study suggests that reasonable trifecta rates can be achieved even by low volume surgeons.
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spelling ‘Trifecta’ outcomes of robot-assisted partial nephrectomy: Results of the ‘low volume’ surgeonNephrectomyRobotic Surgical ProceduresSurgeonsABSTRACT Objective There is limited data regarding surgeon volume and partial nephrectomy outcomes. The aim of this study is to report trifecta outcomes of robot-assisted partial nephrectomy (RAPN) performed by the low volume surgeon. Materials and Methods Thirty-nine patients with clinical T1-2 renal tumors who underwent RAPN between 2012 and 2018 were included in this study. Trifecta was defined as negative surgical margins, warm ischemia time ≤20 minutes, and no operative complications. Patient demographics, R.E.N.A.L. nephrometry score, operation time, estimated blood loss, warm ischemia time, length of hospital stay, renal functions, and oncological outcomes were analyzed retrospectively. Complications were graded based on the modified Clavien-Dindo classification system. Results The median R.E.N.A.L. nephrometry score was 6 (4-10). RAPN was successfully performed in all but one patient. The median operation time was 180 (90-240) minutes. Warm ischemia was performed only by segmental renal artery control in 35 and, by main renal artery control in three patients. The off-clamp technique was used in two patients. The median warm ischemia time was 16 (0-31) minutes. Seven patients had a warm ischemia time of longer than 20 minutes. Three patients had postoperative complications. The surgical margin was positive in one patient. As a result, the trifecta was achieved in 30 of the 39 patients (77%). Conclusion RAPN is a safe and effective minimally invasive alternative in the treatment of renal masses. The present study suggests that reasonable trifecta rates can be achieved even by low volume surgeons.Sociedade Brasileira de Urologia2020-12-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382020000600943International braz j urol v.46 n.6 2020reponame:International Braz J Urol (Online)instname:Sociedade Brasileira de Urologia (SBU)instacron:SBU10.1590/s1677-5538.ibju.2019.0396info:eu-repo/semantics/openAccessBasatac,CemAkpinar,Halukeng2020-09-08T00:00:00Zoai:scielo:S1677-55382020000600943Revistahttp://www.brazjurol.com.br/ONGhttps://old.scielo.br/oai/scielo-oai.php||brazjurol@brazjurol.com.br1677-61191677-5538opendoar:2020-09-08T00:00International Braz J Urol (Online) - Sociedade Brasileira de Urologia (SBU)false
dc.title.none.fl_str_mv ‘Trifecta’ outcomes of robot-assisted partial nephrectomy: Results of the ‘low volume’ surgeon
title ‘Trifecta’ outcomes of robot-assisted partial nephrectomy: Results of the ‘low volume’ surgeon
spellingShingle ‘Trifecta’ outcomes of robot-assisted partial nephrectomy: Results of the ‘low volume’ surgeon
Basatac,Cem
Nephrectomy
Robotic Surgical Procedures
Surgeons
title_short ‘Trifecta’ outcomes of robot-assisted partial nephrectomy: Results of the ‘low volume’ surgeon
title_full ‘Trifecta’ outcomes of robot-assisted partial nephrectomy: Results of the ‘low volume’ surgeon
title_fullStr ‘Trifecta’ outcomes of robot-assisted partial nephrectomy: Results of the ‘low volume’ surgeon
title_full_unstemmed ‘Trifecta’ outcomes of robot-assisted partial nephrectomy: Results of the ‘low volume’ surgeon
title_sort ‘Trifecta’ outcomes of robot-assisted partial nephrectomy: Results of the ‘low volume’ surgeon
author Basatac,Cem
author_facet Basatac,Cem
Akpinar,Haluk
author_role author
author2 Akpinar,Haluk
author2_role author
dc.contributor.author.fl_str_mv Basatac,Cem
Akpinar,Haluk
dc.subject.por.fl_str_mv Nephrectomy
Robotic Surgical Procedures
Surgeons
topic Nephrectomy
Robotic Surgical Procedures
Surgeons
description ABSTRACT Objective There is limited data regarding surgeon volume and partial nephrectomy outcomes. The aim of this study is to report trifecta outcomes of robot-assisted partial nephrectomy (RAPN) performed by the low volume surgeon. Materials and Methods Thirty-nine patients with clinical T1-2 renal tumors who underwent RAPN between 2012 and 2018 were included in this study. Trifecta was defined as negative surgical margins, warm ischemia time ≤20 minutes, and no operative complications. Patient demographics, R.E.N.A.L. nephrometry score, operation time, estimated blood loss, warm ischemia time, length of hospital stay, renal functions, and oncological outcomes were analyzed retrospectively. Complications were graded based on the modified Clavien-Dindo classification system. Results The median R.E.N.A.L. nephrometry score was 6 (4-10). RAPN was successfully performed in all but one patient. The median operation time was 180 (90-240) minutes. Warm ischemia was performed only by segmental renal artery control in 35 and, by main renal artery control in three patients. The off-clamp technique was used in two patients. The median warm ischemia time was 16 (0-31) minutes. Seven patients had a warm ischemia time of longer than 20 minutes. Three patients had postoperative complications. The surgical margin was positive in one patient. As a result, the trifecta was achieved in 30 of the 39 patients (77%). Conclusion RAPN is a safe and effective minimally invasive alternative in the treatment of renal masses. The present study suggests that reasonable trifecta rates can be achieved even by low volume surgeons.
publishDate 2020
dc.date.none.fl_str_mv 2020-12-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
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dc.language.iso.fl_str_mv eng
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dc.relation.none.fl_str_mv 10.1590/s1677-5538.ibju.2019.0396
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dc.publisher.none.fl_str_mv Sociedade Brasileira de Urologia
publisher.none.fl_str_mv Sociedade Brasileira de Urologia
dc.source.none.fl_str_mv International braz j urol v.46 n.6 2020
reponame:International Braz J Urol (Online)
instname:Sociedade Brasileira de Urologia (SBU)
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collection International Braz J Urol (Online)
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