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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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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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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DOI: https://doi.org/10.1007/s00345-015-1569-5