Retroperitoneal laparoscopic partial nephrectomy with selective renal artery clamping for renal cell carcinoma: initial outcomes

Author:

Do Truong-Thanh12,Pham Thanh-Dat34,Do Minh-Tung5,Le Van-Hung6,Nguyen Duc-Minh1,Nguyen Huy-Hoang1,Nguyen Duc-Linh1,Thao Nguyen Dac7,Nguyen Dao-Uyen1

Affiliation:

1. Urology

2. Department of Surgery, Hanoi Medical University, Dong Da District

3. Department of Cardiovascular & Thoracic Surgery, Cardiovascular Center, E Hospital

4. College of Medicine & Pharmacy, Vietnam National University, Cau giay District

5. Department of Surgery, Hai Phong University of Medicine and Pharmacy, Haiphong, Vietnam

6. Department of Gastroenterology-Hepatology-Urology, Vinmec International Hospital, Hai Ba Trung district. Hanoi

7. Coloproctology and Perineology, Viet Duc University Hospital, Hoan Kiem District

Abstract

Introduction: To explore the feasibility and safety of retroperitoneal laparoscopic partial nephrectomy (RLPN) with selective artery clamp (SAC) in patients with renal cell carcinoma (RCC). Methods: The authors recruited three men and two women who underwent RLPN for T1 RCC between December 2022 and May 2023 at a tertiary hospital. The median age of the patients was 32 years (range, 25–70 years). The tumour size ranged from 3 to 4.5 cm. The R.E.N.A.L scores were 4x, 5p, 8a, 5a, and 8ah. The median preoperative eGFR was 96.9 (74.3–105.2). Renal computed tomography angiography was performed before the surgery to evaluate the artery branches. The operation time, number of clamped arteries, warm ischaemic time (WIT), intraoperative blood loss, RCC type, postoperative hospital stay, changes in renal function, and complications were evaluated. The follow-up duration was 6 months. Results: The median operation time was 120 (75–150) minutes. One artery was clamped in four patients, while three were clamped in one patient. The median WIT was 22 (15–30) min, and the median blood loss was 150 (100–300) ml. No complications were recorded, and the resection margin was negative in all patients. The median decrease in eGFR was 6 (4–30%). Conclusions: RLPN with SAC for T1 RCC is safe and feasible in clinical practice.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Reference14 articles.

1. European Association of Urology Guidelines on Renal Cell Carcinoma: The 2022 Update;Ljungberg;Eur Urol,2022

2. Decline in renal function after partial nephrectomy: etiology and prevention;Mir;J Urol,2015

3. Anatomic renal artery branch microdissection to facilitate zero-ischemia partial nephrectomy;Ng;Eur Urol,2012

4. Segmental artery clamping versus main renal artery clamping in nephron-sparing surgery: updated meta-analysis;Xu;World J Surg Oncol,2020

5. Comparison of selective and main renal artery clamping in partial nephrectomy of renal cell cancer: A PRISMA-compliant systematic review and meta-analysis;Zhang;Medicine (United States),2018

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