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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Medicine+(Baltimore)
2015 ; 94
(13
): e692
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Mini-flank supra-12th rib incision for open partial nephrectomy for renal tumor
with RENAL nephrometry score??10: an innovation of traditional open surgery
#MMPMID25837764
Wang H
; Sun LA
; Wang Y
; Xiang Z
; Zhou L
; Guo J
; Wang G
Medicine (Baltimore)
2015[Apr]; 94
(13
): e692
PMID25837764
show ga
The skill of supra-12th rib mini-flank approach for open partial nephrectomy
(MI-OPN) provides an advanced operative method for renal tumor. Compared with
laparoscopic and robotic surgery, it may be a feasible selection for the complex
renal tumors. We describe our techniques and results of MI-OPN in complex renal
tumors with high RENAL nephrometry score (RENAL nephrometry score??10).
Fifty-five patients diagnosed with renal tumors between January 2009 and July
2013 were included in this study. Eligibility criteria comprised of patients with
complex renal tumor (RENAL score??10) being candidates for partial nephrectomy
(PN). All patients received MI-OPN and all surgeries were performed by a single
urologist. The preoperative workup comprised of medical history, physical
examination, and routine laboratory tests. Serum creatinine was recorded
preoperatively and 2 to 3 months after operation. Operative time, ischemia time,
blood loss, operative and postoperative complications, renal function, and
pathology parameters were recorded. MI-OPN was successfully performed in all
cases. Mean tumor size was 4.7?cm (range: 2.5-8.1). Mean warm ischemia time was
28.1 minutes (range: 21-39), mean operative time was 105 minutes (range: 70-150)
and mean estimated blood loss was 68?mL (range: 10-400). Mean postoperative
hospital stay was 6.5 days (range: 5-12). Postoperative complications were found
in 3 patients (5.5%). The mean pre- and postoperative serum creatinine levels
were 76.2??mol/L (range: 47-132) and 87.1??mol/L (range: 61-189) with significant
difference (P?=?0.004). The mean pre- and postoperative estimated glomerular
filtration rate (eGFR) were 91.5 (range: 34-133) and 82.5 (range: 22-126.5),
respectively with significant difference (P?=?0.024). In an average follow-up of
19.9 months (range: 8-50), no local recurrence or systemic progression occurred.
In conclusion, MI-OPN can combine the benefits of both minimal invasive and
traditional open partial nephrectomy (OPN) techniques with a smaller incision. It
is an innovation of traditional OPN and suitable for the complex renal tumors
with high RENAL nephrometry score safely and effectively.