Zero-Ischemia Minimally Invasive Partial Nephrectomy
- 27 July 2013
- journal article
- review article
- Published by Springer Science and Business Media LLC in Current Urology Reports
- Vol. 14 (5), 465-470
- https://doi.org/10.1007/s11934-013-0359-0
Abstract
In the last decade, many authors reported single center experiences of "off-clamp", "clamp-less", or "unclamped" minimally invasive partial nephrectomy (MIPN). These procedures, despite the potential risk of increased intraoperative blood loss, attempted to minimize the loss of renal function by eliminating ischemic renal injury. "Zero ischemia" MIPN has emerged as new treatment option in 2011, initially performed under controlled hypotension, and later mainly by performing a "superselective microdissection". The former technique minimizes the arterial bleeding from the renal stump, allowing surgeon to dissect the tumor in a bloodless field; the latter consists of identifying, antegradely from the renal hilum, the tertiary and quaternary arterial branches directly supplying the kidney neoplasm, and then selectively controlling them before dissecting the renal mass. This review critically analyzes these techniques, focusing on perioperative, oncologic and functional outcomes.Keywords
This publication has 27 references indexed in Scilit:
- Clampless laparoendoscopic single‐site partial nephrectomy for renal cancer with low PADUA score: technique and surgical outcomesBJU International, 2013
- Laparoscopic and Robotic Partial Nephrectomy With Controlled Hypotensive Anesthesia to Avoid Hilar Clamping: Feasibility, Safety and Perioperative Functional OutcomesJournal of Urology, 2012
- Treatment Management of Small Renal Masses in the 21st Century: A Paradigm ShiftAnnals of Surgical Oncology, 2012
- Anatomic Renal Artery Branch Microdissection to Facilitate Zero-Ischemia Partial NephrectomyEuropean Urology, 2012
- ‘Zero ischaemia’, sutureless laparoscopic partial nephrectomy for renal tumours with a low nephrometry scoreBJU International, 2011
- Every Minute Counts When the Renal Hilum Is Clamped During Partial NephrectomyEuropean Urology, 2010
- Laparoscopic Radical Versus Partial Nephrectomy for Tumors >4 cm: Intermediate-term Oncologic and Functional OutcomesUrology, 2009
- Partial Nephrectomy Versus Radical Nephrectomy in Patients With Small Renal Tumors—Is There a Difference in Mortality and Cardiovascular Outcomes?Journal of Urology, 2009
- The effect of hypotensive anaesthesia on cognitive functions and recovery at endoscopic sinus surgeryEuropean Journal of Anaesthesiology, 2005
- Cerebrovascular reactivity in patients with ruptured intracranial aneurysmsJournal of Neurosurgery, 1985