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Comparison of Renal Function between Robot-Assisted and Open Partial Nephrectomy as Determined by Tc 99m-DTPA Renal Scintigraphy.

Lee C, Kwon T, Yoo S, Jung J, Lee C, You D, Jeong IG, Kim CS - J. Korean Med. Sci. (2016)

Bottom Line: Multivariate analysis showed that greater preoperative renal unit function (P = 0.011) and nephrometry score (P = 0.041) were independently correlated with a reduction in glomerular filtration rate.The operative method did not correlate with renal function impairment (P = 0.704).Postoperative renal function impairment was similar between patients who underwent OPN and those who underwent RAPN, despite RAPN having a longer ischemic time.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea .

ABSTRACT
We compared postoperative renal function impairment between patients undergoing robot-assisted partial nephrectomy (RAPN) and those undergoing open partial nephrectomy (OPN) by using Tc-99m diethylenetriaminepentaacetic acid (DTPA) renal scintigraphy. Patients who underwent partial nephrectomy by a single surgeon between 2007 and 2013 were eligible and were matched by propensity score, based on age, tumor size, exophytic properties of tumor, and location relative to the polar lines. Of the 403 patients who underwent partial nephrectomy, 114 (28%) underwent RAPN and 289 (72%) underwent OPN. Mean follow-up duration was 35.2 months. Following propensity matching, there were no significant differences between the two groups in tumor exophytic properties (P = 0.818) or nephrometry score (P = 0.527). Renal ischemic time (24.4 minutes vs. 17.8 minutes, P < 0.001) was significantly longer in the RAPN group than in the OPN group, while the other characteristics were similar. Multivariate analysis showed that greater preoperative renal unit function (P = 0.011) and nephrometry score (P = 0.041) were independently correlated with a reduction in glomerular filtration rate. The operative method did not correlate with renal function impairment (P = 0.704). Postoperative renal function impairment was similar between patients who underwent OPN and those who underwent RAPN, despite RAPN having a longer ischemic time.

No MeSH data available.


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Change in GFR of the operated kidney, before propensity score matching.
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Figure 1: Change in GFR of the operated kidney, before propensity score matching.

Mentions: Table 1 shows the demographic and clinical characteristics of the initial cohort of 403 patients prior to propensity matching. Of these 403 patients, 114 (28.3%) underwent RAPN and 289 (71.7%) underwent OPN. Patients undergoing RAPN were significantly more likely to have exophytic tumors (P < 0.001) and lower nephrometry scores (P = 0.005). In addition, ischemic time was longer in patients who underwent RAPN (23.9 minutes vs. 19.8 minutes, P < 0.001), but hospital stay was shorter (7.1 days vs. 8.7 days, P < 0.001) and the overall complication rate was lower (21.9% vs. 35.8%, P = 0.004). Histologic type of tumor was similar in the two groups (P = 0.223). Follow-up duration after operation was similar in both groups (34.7 months vs. 35.1 months, P = 0.883) and GFR decline at DTPA was also similar (2.0 mL/min/1.73 m2 vs. 2.4 mL/min/1.73 m2, P = 0.774). In Fig. 1, split renal functions of patient are compared, showing no difference between the two operational methods.


Comparison of Renal Function between Robot-Assisted and Open Partial Nephrectomy as Determined by Tc 99m-DTPA Renal Scintigraphy.

Lee C, Kwon T, Yoo S, Jung J, Lee C, You D, Jeong IG, Kim CS - J. Korean Med. Sci. (2016)

Change in GFR of the operated kidney, before propensity score matching.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4835600&req=5

Figure 1: Change in GFR of the operated kidney, before propensity score matching.
Mentions: Table 1 shows the demographic and clinical characteristics of the initial cohort of 403 patients prior to propensity matching. Of these 403 patients, 114 (28.3%) underwent RAPN and 289 (71.7%) underwent OPN. Patients undergoing RAPN were significantly more likely to have exophytic tumors (P < 0.001) and lower nephrometry scores (P = 0.005). In addition, ischemic time was longer in patients who underwent RAPN (23.9 minutes vs. 19.8 minutes, P < 0.001), but hospital stay was shorter (7.1 days vs. 8.7 days, P < 0.001) and the overall complication rate was lower (21.9% vs. 35.8%, P = 0.004). Histologic type of tumor was similar in the two groups (P = 0.223). Follow-up duration after operation was similar in both groups (34.7 months vs. 35.1 months, P = 0.883) and GFR decline at DTPA was also similar (2.0 mL/min/1.73 m2 vs. 2.4 mL/min/1.73 m2, P = 0.774). In Fig. 1, split renal functions of patient are compared, showing no difference between the two operational methods.

Bottom Line: Multivariate analysis showed that greater preoperative renal unit function (P = 0.011) and nephrometry score (P = 0.041) were independently correlated with a reduction in glomerular filtration rate.The operative method did not correlate with renal function impairment (P = 0.704).Postoperative renal function impairment was similar between patients who underwent OPN and those who underwent RAPN, despite RAPN having a longer ischemic time.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea .

ABSTRACT
We compared postoperative renal function impairment between patients undergoing robot-assisted partial nephrectomy (RAPN) and those undergoing open partial nephrectomy (OPN) by using Tc-99m diethylenetriaminepentaacetic acid (DTPA) renal scintigraphy. Patients who underwent partial nephrectomy by a single surgeon between 2007 and 2013 were eligible and were matched by propensity score, based on age, tumor size, exophytic properties of tumor, and location relative to the polar lines. Of the 403 patients who underwent partial nephrectomy, 114 (28%) underwent RAPN and 289 (72%) underwent OPN. Mean follow-up duration was 35.2 months. Following propensity matching, there were no significant differences between the two groups in tumor exophytic properties (P = 0.818) or nephrometry score (P = 0.527). Renal ischemic time (24.4 minutes vs. 17.8 minutes, P < 0.001) was significantly longer in the RAPN group than in the OPN group, while the other characteristics were similar. Multivariate analysis showed that greater preoperative renal unit function (P = 0.011) and nephrometry score (P = 0.041) were independently correlated with a reduction in glomerular filtration rate. The operative method did not correlate with renal function impairment (P = 0.704). Postoperative renal function impairment was similar between patients who underwent OPN and those who underwent RAPN, despite RAPN having a longer ischemic time.

No MeSH data available.


Related in: MedlinePlus