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Inicio Actas Urológicas Españolas (English Edition) Robotic partial nephrectomy: An initial experience in 25 consecutive cases
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Vol. 36. Issue 1.
Pages 15-20 (January 2012)
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Vol. 36. Issue 1.
Pages 15-20 (January 2012)
Original article
DOI: 10.1016/j.acuroe.2011.06.011
Robotic partial nephrectomy: An initial experience in 25 consecutive cases
Nefrectomía parcial robótica: experiencia inicial en 25 casos consecutivos
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O.A. Castilloa,b,c,??
Corresponding author
octavio.castillo@indisa.cl

Corresponding author.
, A. Rodríguez-Carlina, G. López-Fontanaa, I. Vidal-Moraa, R. Gómeza
a Departamento de Urología y Centro de Cirugía Robótica, Clínica Indisa, Santiago, Chile
b Facultad de Medicina, Universidad Andrés Bello, Santiago, Chile
c Facultad de Medicina, Universidad de Chile, Santiago, Chile
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Table 1. Demographic characteristics of the patients.
Table 2. Pathological findings in our series.
Table 3. RPN published series.
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Abstract
Objective

To report our initial experience with robotic partial nephrectomy (RPN) in a series of 25 consecutively operated patients.

Material and methods

A series of 25 consecutive patients who underwent RPN from April 2010 to February 2011 were studied. We used the da Vinci S HD robotic system with transperitoneal approach. Total renal hilum control was used for 22 cases and 3 patients underwent selective renal parenchymal compression with an ad hoc device.

Results

Mean age was 55.8 years (26–77) with a male/female ratio of 2:1. Mean operative time was 117.6min (54–205) and the warm ischemia time was 20.2min (9–34). Mean estimated blood loss was 440ml (20–2000) and the mean tumor size was 3.25cm (1–5.3). Five patients (20%) had complications, the most frequent being intraoperative bleeding (Clavien II). There was no conversion to open or laparoscopic surgery. Mean hospital stay was 3.5 days (1–7). The pathological study revealed renal cell carcinoma in 19 cases and benign lesions in 6 patients. There were no positive surgical margins and no mortality.

Conclusions

Our preliminary results show that RPN is a feasible surgical approach in small-sized renal tumors.

Keywords:
Partial nephrectomy
Robotic surgery
Nephron-sparing surgery
Renal tumor
Resumen
Objetivo

Presentar nuestra experiencia inicial en nefrectomía parcial robótica (NPR) en una serie de 25 pacientes operados de forma consecutiva.

Material y métodos

Se trata de una serie de 25 pacientes consecutivos sometidos a NPR desde abril de 2010 a febrero de 2011. Se utilizó el sistema robótico da Vinci S HD, con abordaje transperitoneal. En 22 casos se utilizó control vascular total del hilio renal y en tres casos se realizó compresión selectiva del parénquima renal con un dispositivo ad hoc.

Resultados

La edad promedio fue de 55,8 años (26-77), con una relación hombre/mujer 2:1. El tiempo operatorio promedio fue de 117,6 minutos (54-205) y el tiempo de isquemia caliente fue de 20,2 minutos (9-34). El sangrado estimado promedio fue de 440ml (20-2.000). El tamaño tumoral promedio fue de 3,25cm (1-5,3). Cinco pacientes (20%) presentaron complicaciones, siendo la hemorragia intraoperatoria la más frecuente (Clavien II). No hubo conversión a cirugía abierta o laparoscópica. La estancia media hospitalaria fue de 3,5 días (1-7). El examen patológico de las lesiones reveló carcinoma renal en 19 casos y lesiones benignas en 6 pacientes. No hubo márgenes quirúrgicos positivos ni mortalidad.

Conclusiones

Nuestros resultados preliminares muestran que la NPR es una alternativa quirúrgica factible de realizar en pacientes con tumores renales de pequeño tamaño.

Palabras clave:
Nefrectomía parcial
Cirugía robótica
Cirugía conservadora de nefronas
Tumor renal

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