Year : 2018 | Volume
: 10 | Issue : 4 | Page : 386--390
Robotic cold ischemia achieves comparable functional outcomes to open cold ischemia during partial nephrectomy for complex kidney tumors
Ryan J Nelson, Julien Dagenais, Matthew J Maurice, Jaya Sai S. Chavalia, Daniel Ramirez, Peter A Caputo, Paurush Babbar, Nitin K Yerram, Jihad H Kaouk
Department of Urology, Glickman Urological and Kidney Institute, Cleveland, Ohio, USA
Objectives: To compare the perioperative and functional outcomes after open and robotic partial nephrectomy performed with cold ischemia.
Methods: A retrospective chart review was completed of consecutive patients who underwent partial nephrectomy with renal hypothermia between January 2011 and September 2016. The study cohort included both open (Open Cold Ischemia, OCI; n=170) and robotic (Robotic Cold Ischemia, RCI; n=31) patients with complex renal masses (R.E.N.A.L. score >7) who did not meet exclusion criteria. A modified intracorporeal technique 1 was utilized for the introduction of ice slush at the time of hilar clamping in the RCI group. Statistical testing was performed to compare key perioperative and functional outcomes after ensuring equilibration of both groups by clinicodemographic criteria.
Results: Both groups were statistically equivalent with respect to baseline characteristics. Median GFR preservation postoperatively was 86.7% for the open group and 86.6% in the robotic group (p=0.49). Cold ischemia time (CIT) in the open group was 35 minutes compared to 28 minutes (p = 0.03) in the robotic group. LOS was significantly shorter by 2 days (p < 0.01) in the robotic group. Positive margins was noted to be 17 (10%) in the open group and 2 (6.5%) patients in the robotic group (p=0.48).
Conclusions: We demonstrate an effective and simplified method of intracorporeal ice cooling during robotic partial nephrectomy. Our data suggests that results with this approach compare favorably to open cold ischemia technique. Intracorporeal ice cooling can be considered when performing complex partial nephrectomies with ischemia times expected to exceed 25 minutes.
Dr. Jihad H Kaouk
Glickman Urology and Kidney Institute, Cleveland Clinic, 9500 Euclid Ave, Q10, Cleveland 44195, Ohio
|How to cite this article:|
Nelson RJ, Dagenais J, Maurice MJ, Chavalia JS, Ramirez D, Caputo PA, Babbar P, Yerram NK, Kaouk JH. Robotic cold ischemia achieves comparable functional outcomes to open cold ischemia during partial nephrectomy for complex kidney tumors.Urol Ann 2018;10:386-390
|How to cite this URL:|
Nelson RJ, Dagenais J, Maurice MJ, Chavalia JS, Ramirez D, Caputo PA, Babbar P, Yerram NK, Kaouk JH. Robotic cold ischemia achieves comparable functional outcomes to open cold ischemia during partial nephrectomy for complex kidney tumors. Urol Ann [serial online] 2018 [cited 2021 Oct 25 ];10:386-390
Available from: https://www.urologyannals.com/article.asp?issn=0974-7796;year=2018;volume=10;issue=4;spage=386;epage=390;aulast=Nelson;type=0