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Expanding utilization of robotic partial nephrectomy for clinical T1b and complex T1a renal masses
- Publication Year :
- 2013
-
Abstract
- INTRODUCTION: Partial nephrectomy is the standard of care for cT1a renal masses, offering equivalent oncologic outcomes and lower renal function impairment when compared to radical nephrectomy, with excellent overall survival results. Robot-assisted partial nephrectomy (RAPN) allows to perform a precise tumor excision, simplifying the reconstruction steps of the procedure, especially in the treatment of complex or large renal tumors. Aim of this study was to summarize the available perioperative, functional, and oncological outcomes of RAPN performed for complex and/or large (cT1b) renal cell carcinoma (RCC). MATERIALS AND METHODS: We performed a nonsystematic review of the literature using a free-text protocol in the Medline database, using the terms "robot-assisted partial nephrectomy" and "robotic partial nephrectomy." Two Authors reviewed separately to select RAPN series reporting data about complex and cT1b RCC. Other significant studies cited in the reference lists of the selected papers were also evaluated. EVIDENCE SYNTHESIS: According to the currently available evidences, RAPN offers promising results in terms of perioperative, functional, and oncological outcomes for the conservative management of complex or large renal tumors, even when compared with open and laparoscopic partial nephrectomy. Robot-assisted procedure allows surgeons to treat large and challenging renal masses, even if with higher warm ischemia time, operating time, and estimated blood loss in comparison with those obtained for the treatment of smaller lesions. CONCLUSIONS: In the hands of experienced surgeons, RAPN is a safe and reproducible approach for the treatment of cT1b and more challenging renal tumors, and could represent the way to expand the indications for minimally invasive conservative approach to RCC.
- Subjects :
- Nephrology
medicine.medical_treatment
kidney carcinoma
Blood Loss, Surgical
Nephrectomy
article, classification, human, ischemia, kidney carcinoma, kidney tumor, laparoscopy, methodology, minimally invasive surgery, nephrectomy, operation duration, operative blood loss, pathology, robotics, treatment outcome, tumor volume
Blood Loss
Surgical, Carcinoma
Renal Cell, Humans, Kidney Neoplasms, Laparoscopy, Nephrectomy, Operative Time, Robotics, Surgical Procedures
Minimally Invasive, Treatment Outcome, Tumor Burden, Warm Ischemia
Renal cell carcinoma
Surgical
Minimally Invasive
Medicine
Warm Ischemia
robotic partial nephrectomy
Laparoscopy
minimally invasive surgery
kidney tumor
medicine.diagnostic_test
article
operation duration
methodology
Robotics
Kidney Neoplasms
Tumor Burden
Treatment Outcome
classification
medicine.medical_specialty
Urology
Operative Time
MEDLINE
Renal function
ischemia
Internal medicine
operative blood loss
Carcinoma
Humans
Minimally Invasive Surgical Procedures
human
Carcinoma, Renal Cell
Surgical Procedures
business.industry
Renal Cell
Perioperative
medicine.disease
Surgery
tumor volume
pathology
business
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....8938dc0adc3a7638cde1b777ea803cd3