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Use of Main Renal Artery Clamping Predominates over Minimal Clamping Techniques during Robotic Partial Nephrectomy for Complex Tumors

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Use of Main Renal Artery Clamping Predominates over Minimal Clamping Techniques during Robotic Partial Nephrectomy for Complex Tumors. / Lieberman, Leedor; Barod, Ravi; Dalela, Deepansh; Diaz-Insua, Mireya; Abaza, Ronney; Adshead, James; Ahlawat, Rajesh; Challacombe, Benjamin; Dasgupta, Prokar; Gandaglia, Giogio; Moon, Daniel A.; Novara, Giacomo; Porpiglia, Francesco; Mottrie, Alexandre; Bhandari, Mahendra; Rogers, Craig.

In: Journal of Endourology, Vol. 31, No. 2, 01.02.2017, p. 149-152.

Research output: Contribution to journalArticle

Harvard

Lieberman, L, Barod, R, Dalela, D, Diaz-Insua, M, Abaza, R, Adshead, J, Ahlawat, R, Challacombe, B, Dasgupta, P, Gandaglia, G, Moon, DA, Novara, G, Porpiglia, F, Mottrie, A, Bhandari, M & Rogers, C 2017, 'Use of Main Renal Artery Clamping Predominates over Minimal Clamping Techniques during Robotic Partial Nephrectomy for Complex Tumors', Journal of Endourology, vol. 31, no. 2, pp. 149-152. https://doi.org/10.1089/end.2016.0678

APA

Lieberman, L., Barod, R., Dalela, D., Diaz-Insua, M., Abaza, R., Adshead, J., Ahlawat, R., Challacombe, B., Dasgupta, P., Gandaglia, G., Moon, D. A., Novara, G., Porpiglia, F., Mottrie, A., Bhandari, M., & Rogers, C. (2017). Use of Main Renal Artery Clamping Predominates over Minimal Clamping Techniques during Robotic Partial Nephrectomy for Complex Tumors. Journal of Endourology, 31(2), 149-152. https://doi.org/10.1089/end.2016.0678

Vancouver

Lieberman L, Barod R, Dalela D, Diaz-Insua M, Abaza R, Adshead J et al. Use of Main Renal Artery Clamping Predominates over Minimal Clamping Techniques during Robotic Partial Nephrectomy for Complex Tumors. Journal of Endourology. 2017 Feb 1;31(2):149-152. https://doi.org/10.1089/end.2016.0678

Author

Lieberman, Leedor ; Barod, Ravi ; Dalela, Deepansh ; Diaz-Insua, Mireya ; Abaza, Ronney ; Adshead, James ; Ahlawat, Rajesh ; Challacombe, Benjamin ; Dasgupta, Prokar ; Gandaglia, Giogio ; Moon, Daniel A. ; Novara, Giacomo ; Porpiglia, Francesco ; Mottrie, Alexandre ; Bhandari, Mahendra ; Rogers, Craig. / Use of Main Renal Artery Clamping Predominates over Minimal Clamping Techniques during Robotic Partial Nephrectomy for Complex Tumors. In: Journal of Endourology. 2017 ; Vol. 31, No. 2. pp. 149-152.

Bibtex Download

@article{a1dcb8b5dacd46efb24a486bfeaa3e97,
title = "Use of Main Renal Artery Clamping Predominates over Minimal Clamping Techniques during Robotic Partial Nephrectomy for Complex Tumors",
abstract = "Introduction: Hilar clamping is often performed to facilitate robotic partial nephrectomy (RPN). Minimal clamping techniques may reduce renal ischemia, including early unclamping, selective clamping, and off-clamp RPN. We assess the utilization of clamping techniques in a large international consortium of surgeons performing RPN for complex tumors.Methods: We retrospectively evaluated 721 patients with complex tumors, who underwent RPN at 11 centers worldwide between 2008 and 2014. Complex tumors were defined as renal masses with a nephrometry score >6. Total clamping was defined as complete clamping of the main renal artery. Minimal clamping techniques included early unclamping, selective clamping, and off-clamp RPN. Clamping techniques were additionally assessed in patients with estimated glomerular filtration rate (eGFR) <60 and in patients with a solitary kidney. Two-tailed t-tests (p < 0.05) were used to statistically analyze differences in mean warm ischemia time (WIT). Results: Most patients underwent complete clamping (75.1%). Minimal clamping (24.9%) included early unclamping (10.8%), selective clamping (8.7%), and off-clamp (5.4%). Mean WIT of total clamping, selective clamping, and early unclamping was 22.2, 21.2, and 17.3 minutes, respectively. Of patients with an eGFR <60 (n = 90), 26.6% underwent minimal clamping, including 15.5% early unclamping, 4.4% selective clamping, and 6.7% off-clamp. Of patients with solitary kidneys (n = 12), 10 (83%) were performed with total clamping with mean WIT of 14.9 minutes. Conclusions: In this large international series of RPN for complex tumors, most patients underwent total clamping of the main renal artery. Minimal clamping techniques, including early unclamping, selective clamping, and off-clamp techniques, were used in a minority of cases. There was no significant increase in use of minimal clamping, even in patients with chronic kidney disease or solitary kidneys. However, mean WIT was low (<23 minutes) in all patient groups.",
keywords = "Clamping, Renal ischemia, Robotic partial nephrectomy",
author = "Leedor Lieberman and Ravi Barod and Deepansh Dalela and Mireya Diaz-Insua and Ronney Abaza and James Adshead and Rajesh Ahlawat and Benjamin Challacombe and Prokar Dasgupta and Giogio Gandaglia and Moon, {Daniel A.} and Giacomo Novara and Francesco Porpiglia and Alexandre Mottrie and Mahendra Bhandari and Craig Rogers",
year = "2017",
month = feb,
day = "1",
doi = "10.1089/end.2016.0678",
language = "English",
volume = "31",
pages = "149--152",
journal = "Journal of Endourology",
issn = "0892-7790",
publisher = "Mary Ann Liebert Inc.",
number = "2",

}

RIS (suitable for import to EndNote) Download

TY - JOUR

T1 - Use of Main Renal Artery Clamping Predominates over Minimal Clamping Techniques during Robotic Partial Nephrectomy for Complex Tumors

AU - Lieberman, Leedor

AU - Barod, Ravi

AU - Dalela, Deepansh

AU - Diaz-Insua, Mireya

AU - Abaza, Ronney

AU - Adshead, James

AU - Ahlawat, Rajesh

AU - Challacombe, Benjamin

AU - Dasgupta, Prokar

AU - Gandaglia, Giogio

AU - Moon, Daniel A.

AU - Novara, Giacomo

AU - Porpiglia, Francesco

AU - Mottrie, Alexandre

AU - Bhandari, Mahendra

AU - Rogers, Craig

PY - 2017/2/1

Y1 - 2017/2/1

N2 - Introduction: Hilar clamping is often performed to facilitate robotic partial nephrectomy (RPN). Minimal clamping techniques may reduce renal ischemia, including early unclamping, selective clamping, and off-clamp RPN. We assess the utilization of clamping techniques in a large international consortium of surgeons performing RPN for complex tumors.Methods: We retrospectively evaluated 721 patients with complex tumors, who underwent RPN at 11 centers worldwide between 2008 and 2014. Complex tumors were defined as renal masses with a nephrometry score >6. Total clamping was defined as complete clamping of the main renal artery. Minimal clamping techniques included early unclamping, selective clamping, and off-clamp RPN. Clamping techniques were additionally assessed in patients with estimated glomerular filtration rate (eGFR) <60 and in patients with a solitary kidney. Two-tailed t-tests (p < 0.05) were used to statistically analyze differences in mean warm ischemia time (WIT). Results: Most patients underwent complete clamping (75.1%). Minimal clamping (24.9%) included early unclamping (10.8%), selective clamping (8.7%), and off-clamp (5.4%). Mean WIT of total clamping, selective clamping, and early unclamping was 22.2, 21.2, and 17.3 minutes, respectively. Of patients with an eGFR <60 (n = 90), 26.6% underwent minimal clamping, including 15.5% early unclamping, 4.4% selective clamping, and 6.7% off-clamp. Of patients with solitary kidneys (n = 12), 10 (83%) were performed with total clamping with mean WIT of 14.9 minutes. Conclusions: In this large international series of RPN for complex tumors, most patients underwent total clamping of the main renal artery. Minimal clamping techniques, including early unclamping, selective clamping, and off-clamp techniques, were used in a minority of cases. There was no significant increase in use of minimal clamping, even in patients with chronic kidney disease or solitary kidneys. However, mean WIT was low (<23 minutes) in all patient groups.

AB - Introduction: Hilar clamping is often performed to facilitate robotic partial nephrectomy (RPN). Minimal clamping techniques may reduce renal ischemia, including early unclamping, selective clamping, and off-clamp RPN. We assess the utilization of clamping techniques in a large international consortium of surgeons performing RPN for complex tumors.Methods: We retrospectively evaluated 721 patients with complex tumors, who underwent RPN at 11 centers worldwide between 2008 and 2014. Complex tumors were defined as renal masses with a nephrometry score >6. Total clamping was defined as complete clamping of the main renal artery. Minimal clamping techniques included early unclamping, selective clamping, and off-clamp RPN. Clamping techniques were additionally assessed in patients with estimated glomerular filtration rate (eGFR) <60 and in patients with a solitary kidney. Two-tailed t-tests (p < 0.05) were used to statistically analyze differences in mean warm ischemia time (WIT). Results: Most patients underwent complete clamping (75.1%). Minimal clamping (24.9%) included early unclamping (10.8%), selective clamping (8.7%), and off-clamp (5.4%). Mean WIT of total clamping, selective clamping, and early unclamping was 22.2, 21.2, and 17.3 minutes, respectively. Of patients with an eGFR <60 (n = 90), 26.6% underwent minimal clamping, including 15.5% early unclamping, 4.4% selective clamping, and 6.7% off-clamp. Of patients with solitary kidneys (n = 12), 10 (83%) were performed with total clamping with mean WIT of 14.9 minutes. Conclusions: In this large international series of RPN for complex tumors, most patients underwent total clamping of the main renal artery. Minimal clamping techniques, including early unclamping, selective clamping, and off-clamp techniques, were used in a minority of cases. There was no significant increase in use of minimal clamping, even in patients with chronic kidney disease or solitary kidneys. However, mean WIT was low (<23 minutes) in all patient groups.

KW - Clamping

KW - Renal ischemia

KW - Robotic partial nephrectomy

UR - http://www.scopus.com/inward/record.url?scp=85020672273&partnerID=8YFLogxK

U2 - 10.1089/end.2016.0678

DO - 10.1089/end.2016.0678

M3 - Article

AN - SCOPUS:85020672273

VL - 31

SP - 149

EP - 152

JO - Journal of Endourology

JF - Journal of Endourology

SN - 0892-7790

IS - 2

ER -

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