Open partial nephrectomy with zero ischaemia using a supra 12th rib miniflank incision: a minimally invasive open approach for small renal masses.
Ehsanullah, Syed Ali Sultana, Abida Kelly, Brian Dunford, Charlotte Shah, Zaheer
Ehsanullah, Syed Ali
Sultana, Abida
Kelly, Brian
Dunford, Charlotte
Shah, Zaheer
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2021-12-31
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Abstract
Introduction: To assess a minimally invasive open technique for partial nephrectomy with zero ischaemia time.
Methods: A review was performed in a prospectively maintained database of a single surgeon series of all patients undergoing partial nephrectomy using a supra 12th rib miniflank incision with zero ischaemia. Data of seventy one patients who underwent a partial nephrectomy over an 82-month period were analyzed. Data analyzed included operative time, estimated blood loss, pre and postoperative renal function, complications, final pathological characteristics, and tumour size.
Results: Seventy one partial nephrectomies were performed from February 2009 to October 2015. None were converted to radical nephrectomy. Mean operative time was 72 minutes (range 30-250), and mean estimated blood loss was 608 mls (range 100-2500) with one patient receiving blood transfusion. The mean pre and postoperative haemoglobin levels were 144 and 112 g/l. The mean pre and postoperative creatinine levels were 82 and 103 Umol/L. There were 8 Clavian-Dindo Grade 2 complications and 1 major complication (Clavian IIIa). Histology confirmed 24 benign lesions and 47 malignant lesions, 46 cT1a lesions, 24 cT1b lesions, and 1 cT2 lesion. Median follow-up was 38 months with no local recurrence or progression of disease with 5 patients having a positive margin (7%).
Conclusion: Our results demonstrate that a supra 12th miniflank incision open partial nephrectomy with zero ischaemic time for SRMs has satisfactory outcomes with preservation of renal function. A minimally invasive open partial nephrectomy remains an important option for units that cannot offer patients a laparoscopic or a robotic procedure.
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Ehsanullah SA, Sultana A, Kelly B, Dunford C, Shah Z. Open Partial Nephrectomy with Zero Ischaemia Using a Supra 12th Rib Miniflank Incision: A Minimally Invasive Open Approach for Small Renal Masses. Adv Urol. 2021 Dec 31;2021:5569254. doi: 10.1155/2021/5569254.
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