Mini-Flank Supra-12th Rib Incision for Open Partial Nephrectomy for Renal Tumor With RENAL Nephrometry Score ≥10. Issue 13 (April 2015)

• Record Type: Journal Article
• Authors: Wang, Hang; Sun, Li-an; Wang, Yiwei; Xiang, Zhuoyi; Zhou, Lin; Guo, Jianming; Wang, Guomin; Bhattacharyya., Gouri Shankar
• Is Part Of: Medicine. Volume 94:Issue 13(2015)
• Publication Date: 2015-04
• Subjects: Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000000692
• Languages: English
• ISSNs: 0025-7974

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Abstract</title> <p>The skill of supra-12th rib mini-flank approach for open partial nephrectomy (MI-OPN) provides an advanced operative method for renal tumor. Compared with laparoscopic and robotic surgery, it may be a feasible selection for the complex renal tumors. We describe our techniques and results of MI-OPN in complex renal tumors with high RENAL nephrometry score (RENAL nephrometry score <bold>≥</bold>10).</p> <p>Fifty-five patients diagnosed with renal tumors between January 2009 and July 2013 were included in this study. Eligibility criteria comprised of patients with complex renal tumor (RENAL score <bold>≥</bold>10) being candidates for partial nephrectomy (PN). All patients received MI-OPN and all surgeries were performed by a single urologist. The preoperative workup comprised of medical history, physical examination, and routine laboratory tests. Serum creatinine was recorded preoperatively and 2 to 3 months after operation. Operative time, ischemia time, blood loss, operative and postoperative complications, renal function, and pathology parameters were recorded.</p> <p>MI-OPN was successfully performed in all cases. Mean tumor size was 4.7 cm (range: 2.5–8.1). Mean warm ischemia time was 28.1 minutes (range: 21–39), mean operative time was 105minutes (range: 70–150) and mean estimated blood loss was 68 mL (range: 10–400). Mean postoperative hospital stay was 6.5 days (range: 5–12). Postoperative complications were found in 3 patients (5.5%). The mean pre- and postoperative serum creatinine levels were 76.2 μmol/L (range: 47–132) and 87.1 μmol/L (range: 61–189) with significant difference (<italic>P</italic> = 0.004). The mean pre- and postoperative estimated glomerular filtration rate (eGFR) were 91.5 (range: 34–133) and 82.5 (range: 22–126.5), respectively with significant difference (<italic>P</italic> = 0.024). In an average follow-up of 19.9 months (range: 8–50), no local recurrence or systemic progression occurred.</p> <p>In conclusion, MI-OPN can combine the benefits of both minimal invasive and traditional open partial nephrectomy (OPN) techniques with a smaller incision. It is an innovation of traditional OPN and suitable for the complex renal tumors with high RENAL nephrometry score safely and effectively.</p> </sec> </abstract>