Dataset Information

The efficacy of modified binding technique for renorrhaphy during robotic partial nephrectomy: surgical and functional outcomes from single-center experience.

ABSTRACT:

Background

To compare the traditional single-layer and double-layer suture renorrhaphy with modified "Binding" suture renorrhaphy (whole rim of the wound was closed by the all-layer flow suture starting from the parenchyma cut edges to hilum, followed by the final defect closure) in robotic partial nephrectomy (RPN) for treating localized renal cell carcinoma in our large institutional experience.

Methods

We retrospectively reviewed clinical data of 406 consecutive patients who underwent RPN from May 2018 and December 2020 in our center. The demographic and oncologic outcome variables were compared between different renal reconstruction groups and the effect of these suture techniques on renal function outcomes was also evaluated.

Results

For the single-layer group, median operative time and warm ischemic time were significantly less than that of the double-layer and "Binding" groups (p < 0.001), while the significantly lower eGFR drop (p = 0.014) was also detected within postoperative 3 months from baseline, but this difference lost its statistical significance from 3th month to the last follow-up. The changes in postoperative creatinine values were clinically insignificant among the three groups. In a sub-analysis over 258 patients with moderate/high nephrometry score, those patients who underwent "Binding" suture had an undifferentiated warm ischemic time, estimated blood loss, and length of hospitalization stay with a decreased risk of Grade III complications (postoperative hemorrhage requiring intervention) and improved renal function recovery during the whole follow-up.

Conclusion

Single-layer suture renorrhaphy may be associated with better renal functional preservation and could prove to be reliable in patients with low-complexity tumor (RENAL score ≤ 6). Patients with moderate/high-complexity tumor (RENAL score ≥ 7) might represent a subgroup of patients having a functional benefit after "Binding" suture renorrhaphy even in the long-term period.

SUBMITTER: Wang ZY

PROVIDER: S-EPMC9839798 | biostudies-literature | 2023 Jan

REPOSITORIES: biostudies-literature

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Publications

The efficacy of modified binding technique for renorrhaphy during robotic partial nephrectomy: surgical and functional outcomes from single-center experience.

Wang Zhi-Yu ZY Zhang Wei W Yu Shuan-Bao SB Zhan Yong-Hao YH Fan Ya-Feng YF Zhang Xue-Pei XP

Surgical endoscopy 20220818 1

<h4>Background</h4>To compare the traditional single-layer and double-layer suture renorrhaphy with modified "Binding" suture renorrhaphy (whole rim of the wound was closed by the all-layer flow suture starting from the parenchyma cut edges to hilum, followed by the final defect closure) in robotic partial nephrectomy (RPN) for treating localized renal cell carcinoma in our large institutional experience.<h4>Methods</h4>We retrospectively reviewed clinical data of 406 consecutive patients who un ...[more]

PMID: 35982285

Similar Datasets

Project description:ObjectivesTo compare the perioperative and postoperative outcomes of transperitoneal and retroperitoneal robotic partial nephrectomy (RPN) and develop a prediction model for reference to select the approach.Materials and methodsWe retrospectively reviewed our single-institutional RPN database. The patients were divided into training and validation sets. In training set, transperitoneal and retroperitoneal cases were matched using propensity score matching to balance confounding factors. The intraoperative and postoperative outcomes of both approaches were compared. A prediction model was constructed to predict the probability of the retroperitoneal approach. The model was then externally validated using the data from the validation set.ResultsA total of 318 patients were included in the training set, and after propensity score matching, 200 cases were left. Additionally, 92 patients were included in the validation set. The estimated blood loss (p = 0.021) and the hemoglobin change (p = 0.016) were greater in the transperitoneal group. There was no significant difference in operative time (p = 0.539), warm ischemia time (p = 0.678), hospitalization time (p = 0.673), extubation time (p = 0.621), creatinine change (p = 0.623), negative margin (p = 1), local recurrence (p = 1), postoperative complication (p = 0.229), long-term creatinine (p = 0.158), and overall survival (p = 0.671) between the two groups. Tumor diameter, anteroposterior location, longitudinal location, and accessory renal artery were employed as variables to construct the prediction model, resulting in area under the curve values of 0.84 and 0.77, respectively, during internal and external validation.ConclusionsRetroperitoneal and transperitoneal approaches of RPN showed no difference in perioperative outcomes except estimated blood loss and hemoglobin change. The retroperitoneal approach is recommended for smaller tumors located in the upper pole or posterior and the presence of an accessory renal artery. Our model is available to predict the probability of the retroperitoneal approach.

Dataset Information

The efficacy of modified binding technique for renorrhaphy during robotic partial nephrectomy: surgical and functional outcomes from single-center experience.

Background

Methods

Results

Conclusion

Publications

The efficacy of modified binding technique for renorrhaphy during robotic partial nephrectomy: surgical and functional outcomes from single-center experience.

Similar Datasets

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