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Curr Opin Urol. 2018 Mar;28(2):123-131. doi: 10.1097/MOU.0000000000000482.

Robot-assisted partial nephrectomy: systematic review of functional results.

Author information

1
Department of Urology, Medical University of Vienna, Vienna, Austria.
2
Department of Urology, Kantonsspital Winterthur, Winterthur, Switzerland.
3
Department of Urology, Jikei University School of Medicine, Tokyo, Japan.
4
Department of Cell and Molecular Biology, University of Medicine and Pharmacy, Tirgu Mures, Romania.
5
Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan.
6
Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria.
7
Department of Urology, Weill Cornell Medical College, New York, New York, USA.
8
Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.

Abstract

PURPOSE OF REVIEW:

Various ischemia type during partial nephrectomy for renal cell cancer (RCC) resulted in different postoperative functional outcomes. Our objective was to systematically review the contemporary literature on robot-assisted partial nephrectomy (RPN) and investigate the association of ischemia type and tumor complexity with postoperative functional outcomes of the operated kidney and overall.

RECENT FINDINGS:

Forty-five of the 99 reports identified were selected for qualitative analysis. All included studies were observational and nonrandomized. Overall, we found that patients undergoing RPN with zero ischemia and selective artery clamping had a lower decrease in glomerular filtration rates of the operated kidney in comparison to both warm and cold ischemia. This association seems also to play a role in patients with bilateral kidneys harboring complex tumors.

SUMMARY:

Zero ischemia and selective artery clamping provide the best functional outcomes following robotic partial nephrectomy. This seems to be of particular relevance in patients with single kidney or tumors of high complexity. Whether these changes are statistically or clinically significant cannot be determined within this systematic review.

PMID:
29278584
DOI:
10.1097/MOU.0000000000000482
[Indexed for MEDLINE]

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