Safety and efficacy of retroperitoneal sutureless zero ischemia laparoscopic partial nephrectomy for low nephrometry score masses

  • Emanuele Corongiu | emanuele.corongiu@libero.it Department of Urology, M.G. Vannini Hospital, Rome, Italy.
  • Pietro Grande Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié Salpétière, Urology Department, Paris, France.
  • Angelo Di Santo Department of Urology, M.G. Vannini Hospital, Rome, Italy.
  • Giorgio Pagliarella Department of Urology, M.G. Vannini Hospital, Rome, Italy.
  • Stefano Squillacciotti Department of Urology, M.G. Vannini Hospital, Rome, Italy.
  • Emanuele Liberati Department of Urology, M.G. Vannini Hospital, Rome, Italy.
  • Alessandra Zampelli Department of Urology, M.G. Vannini Hospital, Rome, Italy.
  • Valerio Olivieri Urology Department, Ivrea Hospital, ASL TO4, Ivrea, Italy.
  • Michele Innocenzi Department of Urology, Bambin Gesù Hospital, Rome, Italy.
  • Flavio Forte Department of Urology, M.G. Vannini Hospital, Rome, Italy.

Abstract

Objectives: To evaluate oncological feasibility and oncological and functional results of retroperitoneal sutureless zero ischemia laparoscopic partial nephrectomy (LPN).
Patients and methods: Patients with posterior renal masses with low nephrometry score (RENAL ≤ 7) treated who underwent retroperitoneal sutureless zero ischemia.in a single center from January 2016 to November 2017. Clinical, surgical and pathological data were prospectively collected. Complications were reported according to the modified Clavien classification.
Results: Retroperitoneal sutureless zero ischemia laparoscopic partial nephrectomy was performed on 15 patients. The indication for nephron-sparing surgery was elective in 11 (73%) patients and imperative in 4 (27%). Median RENAL score was 5 (IQR: 5-7), median tumor diameter 25 mm (IQR: 20-35). In 11 cases, the tumor was located polar (85%), and in 2 cases hilar (15%). There were no intraoperative complications. No cases were converted to radical nephrectomy, and in no case parenchyma suture was necessary. Median operative time was 90 min (IQR:40-150), in no case clamping of the renal artery was necessary, median hospital stay was 4 days, median estimated blood loss (EBL) was 310 (180-500) ml. Pathological analysis showed renal cell carcinoma in 11 patients (85%), 9 (60%) staged T1a and 2 (13%) T1b. In 4 (27%) an oncocytoma was found. There were no positive surgical margins. One patient developed a major postoperative complication (postoperative renal bleeding requiring super-selective embolization). Trifecta rate was 93%.
Conclusions: Sutureless retroperitoneal zero ischemia LPN for the treatment of low-complexity posterior renal masses showed to be safe and feasible. Longer follow-up and higher numbers of patients are, however, warranted to draw definitive conclusions on functional outcomes.

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Published
2019-10-02
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Section
Original Papers - Oncology
Keywords:
Laparoscopy, Kidney cancer, oncological surgery, partial nephrectomy, nephron sparing surgery
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How to Cite
Corongiu, E., Grande, P., Di Santo, A., Pagliarella, G., Squillacciotti, S., Liberati, E., Zampelli, A., Olivieri, V., Innocenzi, M., & Forte, F. (2019). Safety and efficacy of retroperitoneal sutureless zero ischemia laparoscopic partial nephrectomy for low nephrometry score masses. Archivio Italiano Di Urologia E Andrologia, 91(3). https://doi.org/10.4081/aiua.2019.3.157