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10.1097/MD.0000000000000692

http://scihub22266oqcxt.onion/10.1097/MD.0000000000000692
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C4554027!4554027 !25837764
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suck abstract from ncbi


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pmid25837764
      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.
  • |*Ribs [MESH]
  • |Adult [MESH]
  • |Aged [MESH]
  • |Female [MESH]
  • |Humans [MESH]
  • |Intraoperative Complications/epidemiology [MESH]
  • |Kidney Function Tests [MESH]
  • |Kidney Neoplasms/*surgery [MESH]
  • |Male [MESH]
  • |Middle Aged [MESH]
  • |Nephrectomy/adverse effects/*methods [MESH]
  • |Postoperative Complications/epidemiology [MESH]


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