Abstract
Purpose: In this study, we described our initial experience and analyze the learning curve of segmental renal artery branch clamping with hand-assisted laparoscopic partial nephrectomy (PN) using special instruments. Materials and Methods: We conducted a retrospective review of consecutive cases of hand-assisted laparoscopic PN (LPN) between May 2015 and April 2018. Patient demographics, tumor characteristics, perioperative details, postoperative complications, and warm ischemic time for segmental artery branch clamping were included in our analysis. We used the cumulative sum (CUSUM) method to generate learning curves. Results: Segmental renal artery branch clamping was successfully completed in 16 of 20 patients. The median tumor size was 2.9 cm (range, 1.7–7.0 cm), median operation time was 185 minutes (range, 140–245 minutes), median blood loss was 291 mL (range, 100–600 mL), and median hospital stay was 5 days (range, 4–7 days). The median selective ischemic time was 21 minutes (range, 16–35 minutes). No patient had postoperative complications, acute or delayed bleeding. The median pre- and postoperative serum creatinine levels (0.91 and 0.98 mg/dL, respectively), and the pre- and postoperative estimated glomerular filtration rate (89.7 and 79.6 mL/min per 1.73 m2, respectively) were similar. Upon visual assessment of the CUSUM plots, a downward inflection point for decreasing total operation time was observed in the 9th case and estimated blood loss in the 12th case. Conclusions: Our study shows that segmental renal artery branch clamping hand-assisted LPN for localized renal tumors is feasible, safe, and has a relatively short learning curve.
| Original language | English |
|---|---|
| Pages (from-to) | 99-107 |
| Number of pages | 9 |
| Journal | Investigative and Clinical Urology |
| Volume | 60 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - 2019 Mar 1 |
Fingerprint
Keywords
- Ischemia
- Laparoscopy
- Nephrectomy
ASJC Scopus subject areas
- Urology
Cite this
Selective clamping hand-assisted laparoscopic partial nephrectomy for localized renal tumors : A novel technique. / Sik Tae, Bum; Jo Jeon, Byeong; Kim, Nam Cheol; Choi, Hoon; Bae, Jae Hyun; Park, Jae Young.
In: Investigative and Clinical Urology, Vol. 60, No. 2, 01.03.2019, p. 99-107.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Selective clamping hand-assisted laparoscopic partial nephrectomy for localized renal tumors
T2 - A novel technique
AU - Sik Tae, Bum
AU - Jo Jeon, Byeong
AU - Kim, Nam Cheol
AU - Choi, Hoon
AU - Bae, Jae Hyun
AU - Park, Jae Young
PY - 2019/3/1
Y1 - 2019/3/1
N2 - Purpose: In this study, we described our initial experience and analyze the learning curve of segmental renal artery branch clamping with hand-assisted laparoscopic partial nephrectomy (PN) using special instruments. Materials and Methods: We conducted a retrospective review of consecutive cases of hand-assisted laparoscopic PN (LPN) between May 2015 and April 2018. Patient demographics, tumor characteristics, perioperative details, postoperative complications, and warm ischemic time for segmental artery branch clamping were included in our analysis. We used the cumulative sum (CUSUM) method to generate learning curves. Results: Segmental renal artery branch clamping was successfully completed in 16 of 20 patients. The median tumor size was 2.9 cm (range, 1.7–7.0 cm), median operation time was 185 minutes (range, 140–245 minutes), median blood loss was 291 mL (range, 100–600 mL), and median hospital stay was 5 days (range, 4–7 days). The median selective ischemic time was 21 minutes (range, 16–35 minutes). No patient had postoperative complications, acute or delayed bleeding. The median pre- and postoperative serum creatinine levels (0.91 and 0.98 mg/dL, respectively), and the pre- and postoperative estimated glomerular filtration rate (89.7 and 79.6 mL/min per 1.73 m2, respectively) were similar. Upon visual assessment of the CUSUM plots, a downward inflection point for decreasing total operation time was observed in the 9th case and estimated blood loss in the 12th case. Conclusions: Our study shows that segmental renal artery branch clamping hand-assisted LPN for localized renal tumors is feasible, safe, and has a relatively short learning curve.
AB - Purpose: In this study, we described our initial experience and analyze the learning curve of segmental renal artery branch clamping with hand-assisted laparoscopic partial nephrectomy (PN) using special instruments. Materials and Methods: We conducted a retrospective review of consecutive cases of hand-assisted laparoscopic PN (LPN) between May 2015 and April 2018. Patient demographics, tumor characteristics, perioperative details, postoperative complications, and warm ischemic time for segmental artery branch clamping were included in our analysis. We used the cumulative sum (CUSUM) method to generate learning curves. Results: Segmental renal artery branch clamping was successfully completed in 16 of 20 patients. The median tumor size was 2.9 cm (range, 1.7–7.0 cm), median operation time was 185 minutes (range, 140–245 minutes), median blood loss was 291 mL (range, 100–600 mL), and median hospital stay was 5 days (range, 4–7 days). The median selective ischemic time was 21 minutes (range, 16–35 minutes). No patient had postoperative complications, acute or delayed bleeding. The median pre- and postoperative serum creatinine levels (0.91 and 0.98 mg/dL, respectively), and the pre- and postoperative estimated glomerular filtration rate (89.7 and 79.6 mL/min per 1.73 m2, respectively) were similar. Upon visual assessment of the CUSUM plots, a downward inflection point for decreasing total operation time was observed in the 9th case and estimated blood loss in the 12th case. Conclusions: Our study shows that segmental renal artery branch clamping hand-assisted LPN for localized renal tumors is feasible, safe, and has a relatively short learning curve.
KW - Ischemia
KW - Laparoscopy
KW - Nephrectomy
UR - http://www.scopus.com/inward/record.url?scp=85062598115&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85062598115&partnerID=8YFLogxK
U2 - 10.4111/icu.2019.60.2.99
DO - 10.4111/icu.2019.60.2.99
M3 - Article
C2 - 30838342
AN - SCOPUS:85062598115
VL - 60
SP - 99
EP - 107
JO - Investigative and Clinical Urology
JF - Investigative and Clinical Urology
SN - 2466-0493
IS - 2
ER -