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Does tumor rupture during robot-assisted partial nephrectomy have an impact on mid-term tumor recurrences?

Simon Hawlina
Simon Hawlina
, 
Kosta Cerovic
Kosta Cerovic
, 
Andraz Kondza
Andraz Kondza
, 
Peter Popovic
Peter Popovic
, 
Jure Bizjak
Jure Bizjak
 und 
Tomaz Smrkolj
Tomaz Smrkolj
   | 20. Juli 2023
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Article Category: Research Article
Online veröffentlicht: 20. Juli 2023
Seitenbereich: 348 - 355
Eingereicht: 19. Apr. 2023
Akzeptiert: 23. Mai 2023
DOI: https://doi.org/10.2478/raon-2023-0031
Schlüsselwörter
© 2023 Simon Hawlina et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.

FIGURE 1.

(A) Example of tumor rupture during enucleation of a renal tumor. (B) Tumor bed after the tumor was completely removed from healthy kidney parenchyma (intraoperative snapshots).
(A) Example of tumor rupture during enucleation of a renal tumor. (B) Tumor bed after the tumor was completely removed from healthy kidney parenchyma (intraoperative snapshots).

Patient and tumor characteristics in the no tumor rupture group and the tumor rupture group

No tumor rupture (N = 86) Tumor rupture (N = 14) P value
Patients, n (%)
  Male 59 (69) 9 (64) 0.8
  Female 27 (31) 5 (36)
Age (years), median (IQR) 60 (52–67) 60 (49–68) 0.9
Tumor size (mm), median (IQR) 30 (23–40) 37 (30–48) 0.2
RENAL nephrometry score, median (IQR)* 7 (5–8) 8 (6.25–9.75) 0.028
Laterality, n (%)
  Right kidney 40 (47) 6 (43) 0.8
  Left kidney 46 (53) 8 (57)
Tumor localization, n (%)
  Upper third 24 (28) 5(36) 0.8
  Middle third 34 (39) 5 (36)
  Lower third 28 (33) 4 (28)
Preoperative CT/MRI, n (%)
  Tumor 72 (84) 13 (93) 0.4
  Cystic 14 (16) 1 (7)

Pathologic characteristics and oncologic outcome in the no tumor rupture group and the tumor rupture group

No tumor rupture (N = 86), n (%) Tumor rupture (N = 14), n (%) P value
Histology 0.043
  Benign 8 (9) 1 (7)
  Oncocytoma 7 (8) 1 (7)
  Clear cell RCC 44 (51) 2 (14)
  Papillary RCC 15 (17) 8 (57)
  Chromophobe RCC 5 (6) 1 (7)
  Clear cell papillary RCC 4 (5) 0 (0)
  Other types of RCC 3 (3) 1 (7)
WHO/ISUP grade (RCC) 0.6
  1 21 (35) 2 (25)
  2 35 (58) 6 (75)
  3 4 (7) 0 (0)
Pathologic stage 0.4
  1a 58 (82) 9 (75)
  1b 9 (13) 2 (17)
  2a 1 (1) 1 (8)
  3 3 (4) 0 (0)
Positive surgical margins 1 (1) 0 (0) 0.7
Local or distant recurrence 0 (0) 0 (0)

Perioperative and postoperative outcomes in the no tumor rupture group and the tumor rupture group

No tumor rupture (N = 86) Tumor rupture (N = 14) P value
Operative time (min), median (IQR) 140 (115–171) 147 (135–168) 0.4
WIT (min), median (IQR) 15 (12–19) 22 (15–25) 0.026
No clamping, n (%) 8 (9) 0 (0)
Length of stay after surgery (days), median (IQR) 3 (2–3) 3 (2–3) 0.8
Creatinine (μmol/L), median (IQR)
  Preoperative 80 (73–94) 80 (77–87) 0.9
  2 days after RAPN 80 (70–98) 80 (75–89) 0.6
  Variation 1 (−7 to 7) 1 (−7 to 8) 0.7
Intraoperative EBL (mL), median (IQR) 20 (0–50) 50 (20–100) 0.13
Hemoglobin (g/L), median (IQR)
  Preoperative 148 (140–155) 148 (144–152) 0.7
  2 days after RAPN 125 (119–133) 125 (122–129) 0.8
  Variation 22 (14–27) 25 (20–27) 0.6
Transfusions, n (%) 3 (3) 0
Major complications (Clavien-Dindo ≥ 3), n (%) 2 (2) 0
Conversions to radical nephrectomy, n (%) 2 (2) 0 (0)
eISSN:
1581-3207
Sprache:
Englisch
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Medizin, Klinische Medizin, Allgemeinmedizin, Innere Medizin, Hämatologie, Onkologie, Radiologie
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