Partial Nephrectomy for Stage I Renal Cell Carcinoma: On-clamp or Off-clamp?
Journal Title: JOURNAL OF UROLOGICAL SURGERY - Year 2016, Vol 3, Issue 2
Abstract
Objective Partial nephrectomy represents the gold standard surgical procedure for the treatment of small renal cortical tumors. Tumor resection may be performed with the following techniques: on-clamp (warm or cold ischemia) and offclamp (zero-ischemia). We aimed to share our experience with these two techniques and compare treatment outcomes in the present study. Materials and Methods Patients who have undergone open partial nephrectomy for clinical stage I renal cell carcinoma in our department between 2008 and 2012 were enrolled. Group 1 comprised patients with off-clamp technique and group 2 with on-clamp technique. Demographic data, length of operation, length of hospitalization, preoperative estimated glomerular filtration rate (eGFR) and postoperative eGFR on the last visit, complications and requirement of additional procedures, pathologic stage, and surgical margin status were compared between the groups retrospectively. Results A total of 73 patients, 40 in group 1 and 33 in group 2, were included in the study. Mean age, rate of comorbidities, R.E.N.A.L. nephrometry scores, preoperative eGFR, length of operation, length of hospitalization, complications, surgical margin status and additional procedure requirement did not differ significantly between the groups. Transfusion requirement was higher in group 1, however, it did not reach statistical significance (0.7±1.2 U vs. 0.2±0.5 U, p=0.066). After a median follow-up of 27 months for group 1 and 33 months for group 2, postoperative eGFR values were also similar (72.6±31.0 ml/min/1.73 m2 vs. 78.3±22.3 ml/min/1.73 m2, p=0.651). Conclusion Both surgical techniques, on-clamp and off-clamp partial nephrectomy, can be performed according to the surgeons’ preferences safely with similar outcomes.
Authors and Affiliations
Kaan Çömez, Serdar Çelik, Ozan Bozkurt, Ömer Demir, Güven Aslan, Adil Esen
Keywords
Related Articles
- EP ID EP229495
- DOI 10.4274/jus.2016.938
- Views 111
- Downloads 0
Assessment of Risk Factors, Treatment and Hospital Stay in Complicated Urinary Tract Infections in Men Caused by Pseudomonas: A Case-Control Study
Objective: It is known that Pseudomonas has been isolated more frequently in health care-related urinary tract infections (UTIs). It was aimed to determine the risk factors and empiric therapies due to antibiotic resista...
Re: Deep Neuromuscular Blockade Improves Surgical Conditions During Low-Pressure Pneumoperitoneum Laparoscopic Donor Nephrectomy
.
Knowledge Attitude and Behavior in the Domain of Organ Transplantation Among Healthcare Professionals Working in a Tertiary Care Hospital and Patients Admitted to the Urology Clinic
Objective: To measure the knowledge level about organ and tissue donation and to determine the attitudes and behaviors of patients admitted to our hospital as well as healthcare professionals working in our hospital. Mat...
Can Neutrophil/Lymphocyte and Platelet/Lymphocyte Rates Predict Bone Metastasis in Prostate Cancer Patients?
Objective:Bone metastasis is common in advanced prostate cancer (PCa). Recently, there has been a growing interest in the potential role of inflammatory markers, such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-...
Is Anti-platelet Treatment Necessary for Penile Mondor’s Disease?
Objective: The aim of this study was to determine if anti-platelet treatment would have any effect on the rate and duration of resolution in penile Mondor’s disease. Materials and Methods: A retrospective review of patie...