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10.1002/rcs.1738

http://scihub22266oqcxt.onion/10.1002/rcs.1738
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suck abstract from ncbi


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pmid26948671
      Int+J+Med+Robot 2017 ; 13 (1 ): ä
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  • Robotic assisted laparoscopic partial nephrectomy using contrast-enhanced ultrasound scan to map renal blood flow #MMPMID26948671
  • Alenezi A ; Motiwala A ; Eves S ; Gray R ; Thomas A ; Meiers I ; Sharif H ; Motiwala H ; Laniado M ; Karim O
  • Int J Med Robot 2017[Mar]; 13 (1 ): ä PMID26948671 show ga
  • OBJECTIVE: The paper describes novel real-time 'in situ mapping' and 'sequential occlusion angiography' to facilitate selective ischaemia robotic partial nephrectomy (RPN) using intraoperative contrast enhanced ultrasound scan (CEUS). MATERIALS AND METHODS: Data were collected and assessed for 60 patients (61 tumours) between 2009 and 2013. 31 (50.8%) tumours underwent 'Global Ischaemia', 27 (44.3%) underwent 'Selective Ischaemia' and 3 (4.9%) were removed 'Off Clamp Zero Ischaemia'. Demographics, operative variables, complications, renal pathology and outcomes were assessed. RESULTS: Median PADUA score was 9 (range 7-10). The mean warm ischaemia time in selective ischaemia was less and statistically significant than in global ischaemia (17.1 and 21.4, respectively). Mean operative time was 163?min. Postoperative complications (n?=?10) included three (5%) Clavien grade 3 or above. Malignancy was demonstrated in 47 (77%) with negative margin in 43 (91.5%) and positive margin in four (8.5%). Long-term decrease in eGFR post selective ischaemia robotic partial nephrectomy was less compared with global ischaemia (four and eight, respectively) but not statistically significant. CONCLUSIONS: This technique is safe, feasible and cost-effective with comparable perioperative outcomes. The technical aspects elucidate the role of intraoperative CEUS to facilitate and ascertain selective ischaemia. Further work is required to demonstrate long-term oncological outcomes. © 2016 The Authors. The International Journal of Medical Robotics and Computer Assisted Surgery published by John Wiley & Sons, Ltd.
  • |*Renal Circulation [MESH]
  • |*Ultrasonography [MESH]
  • |Adult [MESH]
  • |Aged [MESH]
  • |Angiography [MESH]
  • |Constriction [MESH]
  • |Contrast Media/chemistry [MESH]
  • |Female [MESH]
  • |Glomerular Filtration Rate [MESH]
  • |Humans [MESH]
  • |Ischemia [MESH]
  • |Kidney Neoplasms/*surgery [MESH]
  • |Kidney/diagnostic imaging/surgery [MESH]
  • |Male [MESH]
  • |Middle Aged [MESH]
  • |Monitoring, Intraoperative [MESH]
  • |Nephrectomy/*methods [MESH]
  • |Postoperative Period [MESH]
  • |Reproducibility of Results [MESH]
  • |Robotic Surgical Procedures/*methods [MESH]
  • |Surgery, Computer-Assisted [MESH]
  • |Tomography, X-Ray Computed [MESH]


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