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© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Partial nephrectomy (PN) is the standard procedure for most patients with localized renal cancer. Laparoscopy has become the preferred surgical approach to target this cancer, but the steep learning curve with laparoscopic PN (LPN) remains a concern. In LPN intracorporeal suturing, the operation time is further extended even under robot assistance, a step which prolongs warm ischemic time. Herein, we shared our experience to reduce the warm ischemia time, which allows surgeons to perform LPN more easily by using a combination of hemostatic agents to safely control parenchymal bleeding. Between 2015 and 2018, we enrolled 52 patients who underwent LPN in our hospital. Single-site sutureless LPN and traditional suture methods were performed in 33 and 19 patients, respectively. Preoperative, intra-operative, and postoperative variables were recorded. Renal function was evaluated by estimated glomerular filtration rate (eGFR) pre- and postoperatively. The average warm ischemia time (sutureless vs. suture group; 11.8 ± 3.9 vs. 21.2 ± 7.2 min, p < 0.001) and the operation time (167.9 ± 37.5 vs. 193.7 ± 42.5 min, p = 0.035) were significantly shorter in the sutureless group. In the sutureless group, only 2 patients suffered from massive urinary leakage (>200 mL/day) from the Jackson Pratt drainage tube, but the leakage spontaneously decreased within 7 days after surgery. eGFR and serum hemoglobin were not found to be significantly different pre- and postoperatively. All tumors were removed without a positive surgical margin. All patients were alive without recurrent tumors at mean postoperative follow-ups of 29.3 ± 12.2 months. Single-site sutureless LPN is a feasible surgical method for most patients with small exophytic renal cancer with excellent cosmetic results without affecting oncological results.

Details

Title
Single-Site Sutureless Partial Nephrectomy for Small Exophytic Renal Tumors
Author
Ching-Chia, Li 1 ; Tsu-Ming Chien 2 ; Shu-Pin Huang 3 ; Yeh, Hsin-Chih 4 ; Hsiang-Ying, Lee 4 ; Hung-Lung Ke 2 ; Sheng-Chen, Wen 3 ; Wei-Che, Chang 3 ; Yung-Shun, Juan 5 ; Chou, Yii-Her 2 ; Wen-Jeng, Wu 2 

 Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan; [email protected] (C.-C.L.); [email protected] (S.-P.H.); [email protected] (H.-L.K.); [email protected] (S.-C.W.); [email protected] (W.-C.C.); [email protected] (Y.-S.J.); [email protected] (Y.-H.C.); Department of Urology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80756, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80756, Taiwan; Department of Urology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung 80145, Taiwan; [email protected] (H.-C.Y.); [email protected] (H.-Y.L.) 
 Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan; [email protected] (C.-C.L.); [email protected] (S.-P.H.); [email protected] (H.-L.K.); [email protected] (S.-C.W.); [email protected] (W.-C.C.); [email protected] (Y.-S.J.); [email protected] (Y.-H.C.); Department of Urology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80756, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80756, Taiwan 
 Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan; [email protected] (C.-C.L.); [email protected] (S.-P.H.); [email protected] (H.-L.K.); [email protected] (S.-C.W.); [email protected] (W.-C.C.); [email protected] (Y.-S.J.); [email protected] (Y.-H.C.); Department of Urology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80756, Taiwan 
 Department of Urology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung 80145, Taiwan; [email protected] (H.-C.Y.); [email protected] (H.-Y.L.) 
 Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan; [email protected] (C.-C.L.); [email protected] (S.-P.H.); [email protected] (H.-L.K.); [email protected] (S.-C.W.); [email protected] (W.-C.C.); [email protected] (Y.-S.J.); [email protected] (Y.-H.C.); Department of Urology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80756, Taiwan; Department of Urology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung 80145, Taiwan; [email protected] (H.-C.Y.); [email protected] (H.-Y.L.) 
First page
3658
Publication year
2020
Publication date
2020
Publisher
MDPI AG
e-ISSN
20770383
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2641058995
Copyright
© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.