Predicting positive surgical margins in partial nephrectomy: A prospective multicentre observational study (the RECORd 2 project)

Publication date: Available online 22 January 2020Source: European Journal of Surgical OncologyAuthor(s): Riccardo Schiavina, Andrea Mari, Lorenzo Bianchi, Daniele Amparore, Alessandro Antonelli, Walter Artibani, Eugenio Brunocilla, Umberto Capitanio, Cristian Fiori, Fabrizio Di Maida, Paolo Gontero, Alessandro Larcher, Vincenzo Li Marzi, Nicola Longo, Giancarlo Marra, Emanuele Montanari, Francesco Porpiglia, Marco Roscigno, Claudio Simeone, Salvatore SiracusanoAbstractPurposeto evaluate clinical predictors of positive surgical margins (PSMs) in a large multicenter prospective observational study and to develop a clinic nomogram to predict the likelihood of PSMs after partial nephrectomy (PN).Materials and methodsWe prospectively evaluated 4308 patients who had surgical treatment for renal tumors between January 2013 and December 2016 at 26 urological Italian Centers (RECORd 2 project). Two multivariable logistic models were evaluated to predict the likelihood of PSMs. Center caseload was dichotomized using a visual assessment adjusted for several predictors of PSMs. A nomogram predicting PSMs was developed.ResultsOverall, 2076 patients treated with PN were evaluated. pT1a, pT1b, pT2 and pT3a were recorded in 68.7%, 22.6%, 2.1% and 6.6% of the patients, respectively. PSMs were recorded in 342 (16.5%) patients. From a null multivariable model against number of PN/year, 60 PN/year were identified as the best cut-off to define a high-volume centre. At multivariable analysis,...
Source: European Journal of Surgical Oncology (EJSO) - Category: Surgery Source Type: research

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Conclusions: In conclusion, sufentanil- and fentanyl-based IV-PCA showed similar incidence of PONV with comparable analgesic effects after laparoscopic nephrectomy. Based on these results, we suggest that sufentanil and fentanyl may provide comparable effects for IV-PCA after laparoscopic nephrectomy. PMID: 32038104 [PubMed - in process]
Source: International Journal of Medical Sciences - Category: Biomedical Science Tags: Int J Med Sci Source Type: research
This study retrospectively reviews 1132 patients who underwent 4 different laparoscopic living-donor nephrectomies: hand-assisted laparoscopic nephrectomy (HALDN), pure laparoscopic donor nephrectomy (PLDN), laparoendoscopic single-site plus 1-port donor nephrectomy (LESSOP-DN), and mini laparoscopic donor nephrectomy (MLDN). RESULTS The mean estimated blood loss (EBL) for the HALDN group was meaningfully higher than those of LESSOP-DN and MLDN (57.5±52.2 mL versus 21.0±30.0 mL versus 18.2±28.7 mL) (P
Source: Annals of Transplantation - Category: Transplant Surgery Authors: Tags: Ann Transplant Source Type: research
Journal of Laparoendoscopic&Advanced Surgical Techniques, Ahead of Print.
Source: Journal of Laparoendoscopic and Advanced Surgical Techniques - Category: Surgery Authors: Source Type: research
Laparoscopic nephrectomy is a preferred technique for living kidney donation. However, positive-pressure pneumoperitoneum may have an unfavorable effect on the remaining kidney and other distant organs due to ...
Source: BMC Anesthesiology - Category: Anesthesiology Authors: Tags: Research article Source Type: research
CONCLUSIONS: Partial nephrectomy is still the gold standard treatment for localized renal cell carcinoma, it should be preferably performed by a robot-assisted approach. Focal therapy can serve as an alternative in highly selected cases. PMID: 31974660 [PubMed - as supplied by publisher]
Source: Der Urologe. Ausg. A - Category: Urology & Nephrology Authors: Tags: Urologe A Source Type: research
Journal of Laparoendoscopic&Advanced Surgical Techniques, Ahead of Print.
Source: Journal of Laparoendoscopic and Advanced Surgical Techniques - Category: Surgery Authors: Source Type: research
Authors: Zăhoi DE, Sztika D, Stoican L, Dăescu E Abstract Renal blood vessels present great morphological variability. The routine dissection of a 68-year-old male cadaver revealed multiple bilateral vascular variations associated with the incomplete rotation of both kidneys. The left kidney was supplied by three renal arteries: one superior artery and one middle artery with hilum penetration, and one inferior artery with inferior polar penetration. All three arteries arose from the aorta: two from the anterior side at levels L1 and L3, and one - the inferior artery - from the posterior side of the aorta, as a co...
Source: Romanian Journal of Morphology and Embryology - Category: General Medicine Tags: Rom J Morphol Embryol Source Type: research
Publication date: March 2020Source: Urology Case Reports, Volume 29Author(s): Mesut Demir, Cumhur Yesildal, Abdullah Hizir Yavuzsan, Sinan Levent Kirecci, Ali Ihsan DokucuAbstract46-year-old wife (donor) and 52-year-old husband (recipient) admitted to our clinic for kidney transplantation. CT angiography of the donor showed us there were bilateral renal double artery and a tortuous aorta that is deviated to the left side. The main artery cannot be reached by laparoscopy because of the upper level of renal artery and deviation of the aorta and an open conversion was performed. Presence of tortuous aorta with multiple renal ...
Source: Urology Case Reports - Category: Urology & Nephrology Source Type: research
Conclusions: Several techniques have been described to improve outcomes after RPN. We believe that the literature shows that RPN is as good if not better than both LPN and OPN and has become the preferred surgical approach.
Source: Indian Journal of Urology - Category: Urology & Nephrology Authors: Source Type: research
CONCLUSIONS: The knowledge of the vascular variations of the kidney is essential for surgeons performing kidney transplantation. It is also essential for urologist and vascular surgeons. Incompatible with the literature, the right kidney has more vascular variations and, one kidney artery is found in the majority of Turkish kidney donor patients. PMID: 31886882 [PubMed - as supplied by publisher]
Source: Folia Morphologica - Category: Anatomy Tags: Folia Morphol (Warsz) Source Type: research
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