Does tumor rupture during robot-assisted partial nephrectomy have an impact on mid-term tumor recurrences?
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20 jul 2023
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Categoría del artículo: Research Article
Publicado en línea: 20 jul 2023
Páginas: 348 - 355
Recibido: 19 abr 2023
Aceptado: 23 may 2023
DOI: https://doi.org/10.2478/raon-2023-0031
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© 2023 Simon Hawlina et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.
FIGURE 1.
Patient and tumor characteristics in the no tumor rupture group and the tumor rupture group
| Patients, |
|||
| 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) | |
| Laterality, |
|||
| Right kidney | 40 (47) | 6 (43) | 0.8 |
| Left kidney | 46 (53) | 8 (57) | |
| Tumor localization, |
|||
| Upper third | 24 (28) | 5(36) | 0.8 |
| Middle third | 34 (39) | 5 (36) | |
| Lower third | 28 (33) | 4 (28) | |
| Preoperative CT/MRI, |
|||
| 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
| Histology | |||
| Benign | 8 (9) | 1 (7) | |
| Oncocytoma | 7 (8) | 1 (7) | |
| Clear cell RCC | 2 (14) | ||
| Papillary RCC | 15 (17) | ||
| 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
| Operative time (min), median (IQR) | 140 (115–171) | 147 (135–168) | 0.4 |
| WIT (min), median (IQR) | 15 (12–19) | 22 (15–25) | |
| No clamping, |
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, |
3 (3) | 0 | |
| Major complications (Clavien-Dindo ≥ 3), |
2 (2) | 0 | |
| Conversions to radical nephrectomy, |
2 (2) | 0 (0) | |