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Split renal function of both kidneys after robot-assisted partial nephrectomy for renal tumor larger than 4 cm

  • Urology - Original Paper
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Abstract

Purpose

Relative few studies reported the changes in split renal function using renal scintigraphy for robot-assisted partial nephrectomy (RaPN) for renal tumor >4 cm. This study aimed at demonstrating that RaPN is safe for renal tumor >4 cm without damaging the renal function of ipsilateral and contralateral kidney.

Methods

Patients who underwent RaPN for single renal tumor from December 2009 to December 2013 were identified from a prospectively collected database. We compared demographic, perioperative, and postoperative outcomes between patients with renal tumor >4 cm (case group) and patients with renal tumor ≦4 cm (control group). Renal function was assessed by serum creatinine, estimated glomerular filtration rate, and effective renal plasma flow (ERPF).

Results

One hundred and three consecutive patients (45 in case group and 58 in control group) were identified. Case group had significantly longer operative time (P = 0.011), longer warm ischemia time (P < 0.001), and more estimated blood loss (P = 0.010) than control group. Only one patient in the case group had conversion surgery. There was no significant difference regarding hospital stay, blood transfusion, complications rate, and positive surgical margin. The changes in ipsilateral ERPF and contralateral ERPF were not significantly different between groups (ipsilateral kidney: −10.5 vs. −12.5%, P = 0.989; contralateral kidney: −3.6 vs. −5.2%, P = 0.611).

Conclusions

RaPN is a safe and feasible modality of nephron-sparing surgery for renal tumor >4 cm, as it is for renal tumor ≦4 cm.

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Authors and Affiliations

  1. Department of Urology, Cheng-Hsin General Hospital, Taipei, Taiwan, ROC

    Sheng-Han Tsai

  2. Department of Urology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei, 11217, Taiwan, ROC

    Sheng-Han Tsai & Hsiao-Jen Chung

  3. Department of Urology, School of Medicine and Shu-Tien Urological Research Institute, National Yang-Ming University, Taipei, Taiwan, ROC

    Sheng-Han Tsai & Hsiao-Jen Chung

  4. Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC

    Yi-Chen Lai

  5. Department of Radiology, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC

    Yi-Chen Lai

  6. Institute of Biomedical Informatics, National Yang-Ming University, Taipei, Taiwan, ROC

    Nai-Yuan Wu

Authors
  1. Sheng-Han Tsai
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  2. Yi-Chen Lai
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  3. Nai-Yuan Wu
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  4. Hsiao-Jen Chung
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Correspondence to Hsiao-Jen Chung.

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The authors declare that there are no conflicts of interest related to the subject matter or materials discussed in this article.

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Tsai, SH., Lai, YC., Wu, NY. et al. Split renal function of both kidneys after robot-assisted partial nephrectomy for renal tumor larger than 4 cm. Int Urol Nephrol 49, 225–232 (2017). https://doi.org/10.1007/s11255-016-1463-0

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  • DOI: https://doi.org/10.1007/s11255-016-1463-0

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