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Partial nephrectomy driven by cavitron ultrasonic surgical aspirator under zero ischemia: a pilot study

World Journal of Urology volume 33, pages 2015–2021 (2015)Cite this article

Abstract

Purpose

To investigate the efficacy and technical applicability of cavitron ultrasonic surgical aspirator (CUSA)-driven zero-ischemia open partial nephrectomy in patients with renal tumors.

Materials and methods

We prospectively collected data of 13 consecutive patients, who underwent open partial nephrectomy under non-ischemic conditions. Tumor resection was done using an ultrasonic device (CUSA/SONOCA 300). Demographic and laboratory data, tumor characteristics, perioperative, and postoperative variables were evaluated.

Results

The median age was 60.0 years (range 40–76); body mass index 28.0 kg/m2 (range 22.9–43.3); tumor size 37.0 mm (range 11–110 mm). Patient were stratified according to the PADUA score into low- (score 6–7; n − 4), intermediate- (score 8–9; n − 5), and high-risk (score of >10; n − 4) groups, and the median score was 9.0 (range 6–13; SD +2.3). The vast majority of kidney tumors were diagnosed incidentally (n − 11; 84.6 %). Median operative time was 175 min (55–270 min); median time of tumor extirpation was 12 min (6–25 min); and median blood loss was 250 ml. Serum creatinine, glomerular filtration rate, and hemoglobin were nearly unaltered before and after surgery in 11 cases (84.6 %). Three patients received a blood transfusion (Clavien–Dindo Grade II); one had Grade IIIa complication (insertion of double J stent without general anesthesia); and three had Grade IIIb complications (insertion of double J under general anesthesia).

Conclusions

The ultrasonic device demonstrated acceptable hemostatic and resection properties during open partial nephrectomy without ischemia. Our series showed promising perioperative and postoperative outcomes that may help in maximizing preservation of renal function in partial nephrectomy candidates.

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Abbreviations

BMI:

Body mass index

CT:

Computed tomography

CUSA:

Cavitron ultrasonic surgical aspirator

EBL:

Estimated blood loss

GFR:

Glomerular filtration rate

MRI:

Magnetic resonance imaging

PN:

Partial nephrectomy

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Conflict of interest

I hereby certify that the manuscript or portions thereof are not under considerations by another journal or electronic publication and have not been previously published. Authors fully support this statement.

Ethical standard

An ethical approval for the study was obtained under No. 2145/2013 through the Ethic committee of Medical University in Vienna.

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Affiliations

  1. Department of Urology, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria

    Peter Weibl, Shahrokh F. Shariat & Tobias Klatte

Authors
  1. Peter Weibl
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  2. Shahrokh F. Shariat
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  3. Tobias Klatte
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Correspondence to Peter Weibl.

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Weibl, P., Shariat, S.F. & Klatte, T. Partial nephrectomy driven by cavitron ultrasonic surgical aspirator under zero ischemia: a pilot study. World J Urol 33, 2015–2021 (2015). https://doi.org/10.1007/s00345-015-1569-5

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Keywords

  • Partial nephrectomy
  • Zero ischemia
  • Renal cell cancer