Renal Functional and Perioperative Outcomes of Off-clamp Versus Clamped Robot-assisted Partial Nephrectomy: Matched Cohort Study

Youssef S. Tanagho; Sam B. Bhayani; Gurdarshan S. Sandhu; Nicholas P. Vaughn; Kenneth G. Nepple; R. Sherburne Figenshau

doi:10.1016/j.urology.2012.04.074

Back

Renal Functional and Perioperative Outcomes of Off-clamp Versus Clamped Robot-assisted Partial Nephrectomy: Matched Cohort Study

Journal article

Open access

Peer reviewed

Renal Functional and Perioperative Outcomes of Off-clamp Versus Clamped Robot-assisted Partial Nephrectomy: Matched Cohort Study

Youssef S. Tanagho, Sam B. Bhayani, Gurdarshan S. Sandhu, Nicholas P. Vaughn, Kenneth G. Nepple and R. Sherburne Figenshau

Urology (Ridgewood, N.J.), Vol.80(4), pp.838-844

10/2012

DOI: 10.1016/j.urology.2012.04.074

PMCID: PMC4142222

PMID: 22921704

Files and links (1)

url

https://www.ncbi.nlm.nih.gov/pmc/articles/4142222View

Open Access

Abstract

To evaluate the potential benefit of performing off-clamp robot-assisted partial nephrectomy as it relates to renal functional outcomes, while assessing the safety profile of this unconventional surgical approach. Twenty-nine patients who underwent off-clamp robot-assisted partial nephrectomy for suspected renal cell carcinoma at Washington University between March 2008 and September 2011 (group 1) were matched to 29 patients with identical nephrometry scores and comparable baseline renal function who underwent robot-assisted partial nephrectomy with hilar clamping during the same period (group 2). The matched cohorts' perioperative and renal functional outcomes were compared at a mean 9-month follow-up. Mean estimated blood loss was 146.4 mL in group 1, versus 103.9 mL in group 2 (P = .039). Mean hilar clamp time was 0 minutes in group 1 and 14.7 minutes in group 2. No perioperative complications were encountered in group 1; 1 Clavien-2 complication (3.4%) occurred in group 2 (P = 1.000). At 9-month follow-up, mean estimated glomerular filtration rate in group 1 was 79.9 versus 84.8 mL/min/1.73 m2 preoperatively (P = .013); mean estimated glomerular filtration rate in group 2 was 74.1 versus 85.8 mL/min/1.73 m2 preoperatively (P < .001). Hence, estimated glomerular filtration rate declined by a mean of 4.9 mL/min/1.73 m2 in group 1 versus 11.7 mL/min/1.73 m2 in group 2 (P = .033). Off-clamp robot-assisted partial nephrectomy is associated with a favorable morbidity profile and relatively greater renal functional preservation compared to clamped robot-assisted partial nephrectomy. Nevertheless, the benefit is small in renal functional terms and may have very limited clinical relevance.

Details

Title: Subtitle: Renal Functional and Perioperative Outcomes of Off-clamp Versus Clamped Robot-assisted Partial Nephrectomy: Matched Cohort Study
Creators: Youssef S. Tanagho - Washington University in St. Louis
Sam B. Bhayani - Washington University in St. Louis
Gurdarshan S. Sandhu - Washington University in St. Louis
Nicholas P. Vaughn - Saint Louis University
Kenneth G. Nepple - Washington University in St. Louis
R. Sherburne Figenshau - Washington University in St. Louis
Resource Type: Journal article
Publication Details: Urology (Ridgewood, N.J.), Vol.80(4), pp.838-844
DOI: 10.1016/j.urology.2012.04.074
PMID: 22921704
PMCID: PMC4142222
NLM abbreviation: Urology
ISSN: 0090-4295
eISSN: 1527-9995
Publisher: Elsevier Inc
Language: English
Date published: 10/2012
Academic Unit: Urology
Record Identifier: 9984320854702771

Metrics

9 Record Views

30 Times Cited - Web of Science