Feasibility of omitting cortical renorrhaphy during robot-assisted partial nephrectomy: A matched analysis

Clinton Bahler, Hitesh T. Dube, Kevin J. Flynn, Swapnil Garg, M. Francesca Monn, Luke G. Gutwein, Matthew J. Mellon, Richard Foster, Liang Cheng, Kumar Sandrasegaran, Chandru Sundaram

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

To assess the safety of omitting cortical renorrhaphy during robot-assisted partial nephrectomy and measure preliminary functional outcomes. Patients and Methods: Fifteen robot-assisted partial nephrectomies were performed with a running, base-layer suture for the collecting system and vessel hemostasis but without cortical renorrhaphy. The nonrenorrhaphy group was matched 1:2 by R.E.N.A.L. nephrometry score to a running, sliding-clip cortical renorrhaphy group retrospectively. Intraoperative blood loss, urine leaks, postoperative bleeds, and functional outcomes were evaluated. Predictors of %volume loss were evaluated using multivariable regression. Results: No differences were seen between renorrhaphy and nonrenorrhaphy in sex (P=0.53), age (P=0.14), body mass index (P=0.08), Charlson score (P=0.44), tumor diameter (P=0.55), nephrometry score (P=0.77), preoperative glomerular filtration rate (GFR, P=0.63), or the amount of resected healthy kidney margin (P=0.21). Warm ischemia time was less for the nonrenorrhaphy group (P3 for renorrhaphy and 9 cm3 for nonrenorrhaphy (P=0.003). In a multivariable model, both cortical renorrhaphy (P=0.004) and tumor diameter (P=0.004) were predictors of %volume loss. Conclusion: Omission of cortical renorrhaphy appears feasible with no urine leaks or bleeding complications observed. The percent renal volume loss was improved by omission of cortical renorrhaphy. Reconstruction technique is important to control for when studying renal function after partial nephrectomy.

Original languageEnglish (US)
Pages (from-to)548-555
Number of pages8
JournalJournal of Endourology
Volume29
Issue number5
DOIs
StatePublished - May 1 2015

Fingerprint

Nephrectomy
Kidney
Urine
Warm Ischemia
Hemostasis
Glomerular Filtration Rate
Surgical Instruments
Sutures
Neoplasms
Body Mass Index
Research Design
Hemorrhage
Safety

ASJC Scopus subject areas

  • Urology

Cite this

Feasibility of omitting cortical renorrhaphy during robot-assisted partial nephrectomy : A matched analysis. / Bahler, Clinton; Dube, Hitesh T.; Flynn, Kevin J.; Garg, Swapnil; Monn, M. Francesca; Gutwein, Luke G.; Mellon, Matthew J.; Foster, Richard; Cheng, Liang; Sandrasegaran, Kumar; Sundaram, Chandru.

In: Journal of Endourology, Vol. 29, No. 5, 01.05.2015, p. 548-555.

Research output: Contribution to journalArticle

Bahler, Clinton ; Dube, Hitesh T. ; Flynn, Kevin J. ; Garg, Swapnil ; Monn, M. Francesca ; Gutwein, Luke G. ; Mellon, Matthew J. ; Foster, Richard ; Cheng, Liang ; Sandrasegaran, Kumar ; Sundaram, Chandru. / Feasibility of omitting cortical renorrhaphy during robot-assisted partial nephrectomy : A matched analysis. In: Journal of Endourology. 2015 ; Vol. 29, No. 5. pp. 548-555.
@article{0a72c4063afa41e1bccd28adea930dd1,
title = "Feasibility of omitting cortical renorrhaphy during robot-assisted partial nephrectomy: A matched analysis",
abstract = "To assess the safety of omitting cortical renorrhaphy during robot-assisted partial nephrectomy and measure preliminary functional outcomes. Patients and Methods: Fifteen robot-assisted partial nephrectomies were performed with a running, base-layer suture for the collecting system and vessel hemostasis but without cortical renorrhaphy. The nonrenorrhaphy group was matched 1:2 by R.E.N.A.L. nephrometry score to a running, sliding-clip cortical renorrhaphy group retrospectively. Intraoperative blood loss, urine leaks, postoperative bleeds, and functional outcomes were evaluated. Predictors of {\%}volume loss were evaluated using multivariable regression. Results: No differences were seen between renorrhaphy and nonrenorrhaphy in sex (P=0.53), age (P=0.14), body mass index (P=0.08), Charlson score (P=0.44), tumor diameter (P=0.55), nephrometry score (P=0.77), preoperative glomerular filtration rate (GFR, P=0.63), or the amount of resected healthy kidney margin (P=0.21). Warm ischemia time was less for the nonrenorrhaphy group (P3 for renorrhaphy and 9 cm3 for nonrenorrhaphy (P=0.003). In a multivariable model, both cortical renorrhaphy (P=0.004) and tumor diameter (P=0.004) were predictors of {\%}volume loss. Conclusion: Omission of cortical renorrhaphy appears feasible with no urine leaks or bleeding complications observed. The percent renal volume loss was improved by omission of cortical renorrhaphy. Reconstruction technique is important to control for when studying renal function after partial nephrectomy.",
author = "Clinton Bahler and Dube, {Hitesh T.} and Flynn, {Kevin J.} and Swapnil Garg and Monn, {M. Francesca} and Gutwein, {Luke G.} and Mellon, {Matthew J.} and Richard Foster and Liang Cheng and Kumar Sandrasegaran and Chandru Sundaram",
year = "2015",
month = "5",
day = "1",
doi = "10.1089/end.2014.0763",
language = "English (US)",
volume = "29",
pages = "548--555",
journal = "Journal of Endourology",
issn = "0892-7790",
publisher = "Mary Ann Liebert Inc.",
number = "5",

}

TY - JOUR

T1 - Feasibility of omitting cortical renorrhaphy during robot-assisted partial nephrectomy

T2 - A matched analysis

AU - Bahler, Clinton

AU - Dube, Hitesh T.

AU - Flynn, Kevin J.

AU - Garg, Swapnil

AU - Monn, M. Francesca

AU - Gutwein, Luke G.

AU - Mellon, Matthew J.

AU - Foster, Richard

AU - Cheng, Liang

AU - Sandrasegaran, Kumar

AU - Sundaram, Chandru

PY - 2015/5/1

Y1 - 2015/5/1

N2 - To assess the safety of omitting cortical renorrhaphy during robot-assisted partial nephrectomy and measure preliminary functional outcomes. Patients and Methods: Fifteen robot-assisted partial nephrectomies were performed with a running, base-layer suture for the collecting system and vessel hemostasis but without cortical renorrhaphy. The nonrenorrhaphy group was matched 1:2 by R.E.N.A.L. nephrometry score to a running, sliding-clip cortical renorrhaphy group retrospectively. Intraoperative blood loss, urine leaks, postoperative bleeds, and functional outcomes were evaluated. Predictors of %volume loss were evaluated using multivariable regression. Results: No differences were seen between renorrhaphy and nonrenorrhaphy in sex (P=0.53), age (P=0.14), body mass index (P=0.08), Charlson score (P=0.44), tumor diameter (P=0.55), nephrometry score (P=0.77), preoperative glomerular filtration rate (GFR, P=0.63), or the amount of resected healthy kidney margin (P=0.21). Warm ischemia time was less for the nonrenorrhaphy group (P3 for renorrhaphy and 9 cm3 for nonrenorrhaphy (P=0.003). In a multivariable model, both cortical renorrhaphy (P=0.004) and tumor diameter (P=0.004) were predictors of %volume loss. Conclusion: Omission of cortical renorrhaphy appears feasible with no urine leaks or bleeding complications observed. The percent renal volume loss was improved by omission of cortical renorrhaphy. Reconstruction technique is important to control for when studying renal function after partial nephrectomy.

AB - To assess the safety of omitting cortical renorrhaphy during robot-assisted partial nephrectomy and measure preliminary functional outcomes. Patients and Methods: Fifteen robot-assisted partial nephrectomies were performed with a running, base-layer suture for the collecting system and vessel hemostasis but without cortical renorrhaphy. The nonrenorrhaphy group was matched 1:2 by R.E.N.A.L. nephrometry score to a running, sliding-clip cortical renorrhaphy group retrospectively. Intraoperative blood loss, urine leaks, postoperative bleeds, and functional outcomes were evaluated. Predictors of %volume loss were evaluated using multivariable regression. Results: No differences were seen between renorrhaphy and nonrenorrhaphy in sex (P=0.53), age (P=0.14), body mass index (P=0.08), Charlson score (P=0.44), tumor diameter (P=0.55), nephrometry score (P=0.77), preoperative glomerular filtration rate (GFR, P=0.63), or the amount of resected healthy kidney margin (P=0.21). Warm ischemia time was less for the nonrenorrhaphy group (P3 for renorrhaphy and 9 cm3 for nonrenorrhaphy (P=0.003). In a multivariable model, both cortical renorrhaphy (P=0.004) and tumor diameter (P=0.004) were predictors of %volume loss. Conclusion: Omission of cortical renorrhaphy appears feasible with no urine leaks or bleeding complications observed. The percent renal volume loss was improved by omission of cortical renorrhaphy. Reconstruction technique is important to control for when studying renal function after partial nephrectomy.

UR - http://www.scopus.com/inward/record.url?scp=84928955379&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84928955379&partnerID=8YFLogxK

U2 - 10.1089/end.2014.0763

DO - 10.1089/end.2014.0763

M3 - Article

C2 - 25616087

AN - SCOPUS:84928955379

VL - 29

SP - 548

EP - 555

JO - Journal of Endourology

JF - Journal of Endourology

SN - 0892-7790

IS - 5

ER -