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Retroperitoneoscopic partial nephrectomy using a 980/1470-nm dual-diode laser for small exophytic renal tumors

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Abstract

Laser-supported laparoscopic partial nephrectomy is a promising new technique, but remains under experiment. We presented our single institutional experience of laparoscopic partial nephrectomy using the 980/1470-nm dual-diode laser system to investigate its feasibility, and oncological and functional outcomes. The study retrospectively evaluated 25 patients with small exophytic renal tumors, who underwent laparoscopic partial nephrectomy using a 980/1470-nm dual-diode laser. The demographics, surgical data, complications, pathological variables, oncological, and functional outcomes were reviewed. The changes in hemoglobin and estimated glomerular filtration rate (eGFR) before and after surgery were statistically analyzed. The investigators operated on a total of 25 patients. The off-clamping technique was performed for 23 cases, while the other two cases required renal artery clamping due to unsatisfactory hemostasis. The tumor diameter was 24.6± 6.2 mm, and the mean operative time was 104.4± 23.4 min. The median estimated intraoperative blood loss (EBL) was 100 ml (range 50–600 ml). No major complications (Clavien-Dindo >II) occurred perioperatively. The mean change in hemoglobin before and after the operation was 9 g/l, with a P value of <0.001. The mean decrease in eGFR from before the surgery to the 6-month follow-up was 1.4 ml/min, with a P value of 0.463. The postoperative histopathology evaluation did not demonstrate a positive surgical margin. No recurrence or metastasis was found during the follow-up (mean 24 months). Laparoscopic partial nephrectomy using a 980/1470 nm dual-diode laser appears to be a feasible and oncological satisfactory technique for the treatment of small renal mass (SRM), with the advantages of reducing warm ischemia time.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. Ferlay J et al (2018) Cancer incidence and mortality patterns in Europe: Estimates for 40 countries and 25 major cancers in 2018. Eur J Cancer 103:356–387

    Article  CAS  Google Scholar 

  2. Conti A et al (2015) Small renal masses in the era of personalized medicine: tumor heterogeneity, growth kinetics, and risk of metastasis. Urol Oncol 33(7):303–309

    Article  Google Scholar 

  3. Ljungberg B et al (2010) EAU guidelines on renal cell carcinoma: the 2010 update. Eur Urol 58(3):398–406

    Article  Google Scholar 

  4. MacLennan S et al (2012) Systematic review of perioperative and quality-of-life outcomes following surgical management of localised renal cancer. Eur Urol 62(6):1097–1117

    Article  Google Scholar 

  5. Thompson RH et al (2010) Every minute counts when the renal hilum is clamped during partial nephrectomy. Eur Urol 58(3):340–345

    Article  Google Scholar 

  6. Volpe A et al (2015) Renal ischemia and function after partial nephrectomy: a collaborative review of the literature. Eur Urol 68(1):61–74

    Article  Google Scholar 

  7. Muramaki M et al (2013) Prognostic factors influencing postoperative development of chronic kidney disease in patients with small renal tumors who underwent partial nephrectomy. Curr Urol 6(3):129–135

    Article  Google Scholar 

  8. Hou W, Ji Z (2015) Achieving zero ischemia in minimally invasive partial nephrectomy surgery. Int J Surg 18:48–54

    Article  Google Scholar 

  9. Loertzer H, Strauß A, Ringert RH et al (2013) Laser-supported partial laparoscopic nephrectomy for renal cell carcinoma without ischaemia time. BMC Urol 13:31

    Article  Google Scholar 

  10. Gofrit ON et al (2012) Laparoscopic partial nephrectomy using a flexible CO2 laser fiber. JSLS 16(4):588–591

    Article  Google Scholar 

  11. Clayman RV (2005 Apr) Laparoscopic partial nephrectomy using holmium laser in a porcine model. J Urol 173(4):1200–1201

    PubMed  Google Scholar 

  12. Rioja J et al (2017) Laparoscopic partial nephrectomy with potassium-titanyl-phosphate laser versus conventional laparoscopic partial nephrectomy: an animal randomized controlled trial. Urology 99:123–130

    Article  Google Scholar 

  13. Khoder WY et al (2012) Outcome of laser-assisted laparoscopic partial nephrectomy without ischaemia for peripheral renal tumours. World J Urol 30(5):633–638

    Article  Google Scholar 

  14. Wang Y et al (2019) Thulium laser-assisted versus conventional laparoscopic partial nephrectomy for the small renal mass. Lasers Surg Med

  15. Knezevic N et al (2014) Laparoscopic partial nephrectomy with diode laser: a promising technique. Photomed Laser Surg 32(2):101–105

    Article  Google Scholar 

  16. Thomas AZ et al (2013) Zero ischemia laparoscopic partial thulium laser nephrectomy. J Endourol 27(11):1366–1370

    Article  Google Scholar 

  17. Anderson JK et al (2007) Large-volume laparoscopic partial nephrectomy using the potassium-titanyl-phosphate (KTP) laser in a survival porcine model. Eur Urol 51(3):749–754

    Article  Google Scholar 

  18. Khoder WY et al (2011) The 1,318-nm diode laser supported partial nephrectomy in laparoscopic and open surgery: preliminary results of a prospective feasibility study. Lasers Med Sci 26(5):689–697

    Article  Google Scholar 

  19. Hindley RG et al (2006) Laparoscopic partial nephrectomy using the potassium titanyl phosphate laser in a porcine model. Urology 67(5):1079–1083

    Article  CAS  Google Scholar 

  20. Arkhipova V et al (2019) Ex vivo and animal study of the blue diode laser, Tm fiber laser, and their combination for laparoscopic partial nephrectomy. Lasers Surg Med. https://doi.org/10.1002/lsm.23158

  21. Browne C et al (2017) A single centre experience of zero-ischaemia laparoscopic partial nephrectomy in Ireland. Ir J Med Sci 186(4):1023–1026

    Article  CAS  Google Scholar 

  22. Lotan Y et al (2002) Clinical use of the holmium: YAG laser in laparoscopic partial nephrectomy. J Endourol 16(5):289–292

    Article  Google Scholar 

  23. Kyriazis I et al (2015) Current evidence on lasers in laparoscopy: partial nephrectomy. World J Urol 33(4):589–594

    Article  Google Scholar 

  24. Drerup M et al (2018) Non-ischemic laparoscopic partial nephrectomy using 1318-nm diode laser for small exophytic renal tumors. BMC Urol 18(1):99

    Article  Google Scholar 

  25. Rosenthal BD, DiTrolio JV (2012) Photoselective vaporization of the prostate in office and outpatient settings. Can J Urol 19(2):6223–6226

    PubMed  Google Scholar 

  26. Kutikov A, Uzzo RG (2009) The R.E.N.A.L. nephrometry score: a comprehensive standardized system for quantitating renal tumor size, location and depth. J Urol 182(3):844–853

    Article  Google Scholar 

  27. Ficarra V et al (2009) Preoperative aspects and dimensions used for an anatomical (PADUA) classification of renal tumours in patients who are candidates for nephron-sparing surgery. Eur Urol 56(5):786–793

    Article  Google Scholar 

  28. Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240(2):205–213

    Article  Google Scholar 

  29. Arkhipova V et al (2020) Ex Vivo and animal study of the blue diode laser, Tm fiber laser, and their combination for laparoscopic partial nephrectomy. Lasers Surg Med 52(5):437–448

    Article  Google Scholar 

  30. Lane BR et al (2008) Comparison of laparoscopic and open partial nephrectomy for tumor in a solitary kidney. J Urol 179(3):847–851 discussion 852

    Article  Google Scholar 

  31. Bui MH et al (2007) Less smoke and minimal tissue carbonization using a thulium laser for laparoscopic partial nephrectomy without hilar clamping in a porcine model. J Endourol 21(9):1107–1111

    Article  Google Scholar 

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Funding

This work was supported by institutional research funding provided by the Fundamental Research Funds for the Central Universities (grant no. 3332020004) (J.D.).

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Authors and Affiliations

  1. Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China

    Jie Dong, Weifeng Xu, Guanghua Liu, Yi Xie, Yi Qiao & Zhigang Ji

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  1. Jie Dong
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  2. Weifeng Xu
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  3. Guanghua Liu
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  4. Yi Xie
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  5. Yi Qiao
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  6. Zhigang Ji
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Contributions

JD, WFX, and GHL performed the research; YX and YQ collected clinical data; JD wrote the manuscript; WFX and ZGJ supervised the study and revised the manuscript.

Corresponding author

Correspondence to Weifeng Xu.

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This study was performed in accordance with relevant guidelines and regulations and was approved by the PUMCH Ethics Committee.

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Informed consent was achieved from all patients for the utilization of their medical records.

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The authors declare no competing interests.

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Dong, J., Xu, W., Liu, G. et al. Retroperitoneoscopic partial nephrectomy using a 980/1470-nm dual-diode laser for small exophytic renal tumors. Lasers Med Sci 37, 471–477 (2022). https://doi.org/10.1007/s10103-021-03284-3

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  • DOI: https://doi.org/10.1007/s10103-021-03284-3

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