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World Journal of Clinical Cases 2021年第23期9卷 6879-6885页

作者： Ying-Ming Xiao Sheng-Ke Yang Ying Wang Dun Mao Fang-Lei Duan Shu-Kui Zhou Department of Urology Sichuan Cancer Hospital and InstituteSichuan Cancer CenterSchool of MedicineUniversity of Electronic Science and Technology of ChinaChengdu 610041Sichuan ProvinceChina Department of Urology Affiliated Sixth People’s HospitalShanghai Jiao Tong UniversityShanghai 200233China Department of Pathology Sichuan Cancer Hospital and InstituteSichuan Cancer CenterSchool of MedicineUniversity of Electronic Science and Technology of ChinaChengdu 610041Sichuan ProvinceChina

BACKGROUND The majority of renal cell carcinomas are single lesions;unilateral synchronous multifocal renal carcinoma(USMRC)is rarely reported and poses a treatment challenge for urological *** SUMMARY A 56-year-old man was hospitalized for pain and discomfort in the right kidney area for 6 ***-enhanced computed tomography demonstrated cT1a renal tumors at the lower pole of the right kidney and a cT1b renal tumor at the middle dorsal portion of the right *** patient underwent retroperitoneal laparoscopic partial nephrectomy(RLPN).There were no complications *** revealed a low-grade,pathologic stage T1a(pT1a),clear cell renal cell carcinoma at the lower pole of the right kidney and a pT1b,chromophobe renal cell carcinoma at the middle dorsal portion of the right *** tumor bed recurrence or metastasis was observed on imaging and his renal function remained stable during the 12-mo follow-up *** RLPN is a safe,effective,and feasible for the management of USMRC,which can obtain equivalent oncological results with optimal renal function preservation.

关键词： Kidney neoplasm Multifocal Retroperitoneal laparoscopic operation partial nephrectomy Case report

“Zero ischemia”laparoscopic partial nephrectomy by high-power GreenLight laser enucleation for renal carcinoma:A single-center experience

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World Journal of Clinical Cases 2022年第17期10卷 5646-5654页

作者： Xiang-Min Zhang Ji-Dong Xu Jian-Min Lv Xiu-Wu Pan Jian-Wei Cao Jian Chu Xin-Gang Cui Department of Urology Xinhua HospitalShanghai Jiaotong UniversitySchool of MedicineShanghai 200092China Department of Urology Shanghai Baoshan Luodian HospitalShanghai 201908China Department of Urology Gongli Hospital of The Second Military Medical UniversityShanghai 200135China Department of Urology Shanghai The Seventh People's HospitalShanghai 200137China

BACKGROUND Laparoscopic partial nephrectomy has been widely used in renal cell carcinoma *** efficacy of GreenLight laser on Laparoscopic partial nephrectomy is still *** To present the first series of laparoscopic partial nephrectomy(LPN)by GreenLight laser enucleation without renal artery *** to the excellent coagulation and hemostatic properties of the laser,laser-assisted LPN(LLPN)makes it possible to perform a“zero ischemia”*** Fifteen patients with T1a exogenous renal tumors who received high-power GreenLight laser non-ischemic LPN in our hospital were retrospectively *** clinical information,surgical and post-operative data,complications,pathological and functional outcomes were *** Surgery was successfully completed in all patients,and no open or radical nephrectomy was *** renal artery was not clamped,leading to no ischemic *** blood transfusions were required,the average hemoglobin level ranged from 96.0 to 132.0 g/L and no postoperative complications *** mean operation time was 104.3±8.2 *** postoperative removal of negative pressure drainage time ranged from 5.0 to 7.0 d,and the mean postoperative hospital stay was 6.5±0.7 *** serious complications *** pathological results showed clear cell carcinoma in 12 patients,papillary renal cell carcinoma in 2 patients,and hamartoma in 1 *** mean creatinine level was 75.0±0.8μmol/L(range 61.0-90.4μmol/L)at 1 mo after surgery,and there were no statistically significant differences compared with pre-operation(P>0.05).The glomerular filtration rate ranged from 45.1 to 60.8 mL/min,with an average of 54.0±5.0 mL/min,and these levels were not significantly different from those before surgery(P>0.05).CONCLUSION GreenLight laser has extraordinary cutting and sealing advantages when used for small renal tumors(exogenous tumors of stage T1a)during ***,use of this technique can lead to the generation

关键词： GreenLight laser Zero ischemia partial nephrectomy Laparoscopy Renal tumor

Migration of a Hem-o-Lok clip to the renal pelvis after laparoscopic partial nephrectomy:A case report

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World Journal of Clinical Cases 2022年第10期10卷 3188-3193页

作者： Ji Sun Li-Wei Zhao Xu-Liang Wang Jia-Guo Huang Yi Fan Department of Urology The Affiliated Xiaoshan HospitalHangzhou Normal UniversityHangzhou 311202Zhejiang ProvinceChina Department of Urology School of MedicineHangzhou Normal UniversityHangzhou 311121Zhejiang ProvinceChina Department of Urology The Affiliated Hangzhou First People's HospitalZhejiang University School of MedicineHangzhou 310006Zhejiang ProvinceChina

BACKGROUND Hem-o-Lok clip(HOLC)has been widely used in laparoscopic surgery due to its ease of application and secure clamping,though the rare complications associated with this technique should not be *** rare complications of laparoscopic partial nephrectomy consist of the clip migrating into the renal pelvis and acting as a nidus for stone *** SUMMARY The case described here involved a 63-year-old woman who was found with stones in the right kidney and upper ureter during a recent reexamination following laparoscopic partial *** performed percutaneous nephrolithotomy for her,but during the operation,it was found that the center of the stone within the kidney was a HOLC,which was removed with *** this reason,we speculate that the HOLC,which was employed to halt tumor wound bleeding,spontaneously drifted into the renal pelvis and formed kidney stones,with the clip being initially misdiagnosed as a kidney *** By reviewing related case reports,we conclude that in order to prevent complications related to HOLC,loose clips should be actively searched for and retrieved from the wound during urinary tract surgery,while the deployment of clips in close proximity of anastomotic stoma of collecting systems should be avoided.

关键词： partial nephrectomy Foreign body stones Hem-o-Lok(surgical instrument) Case report

Comparison of the oncological,perioperative and functional outcomes of partial nephrectomy versus radical nephrectomy for clinical T1b renal cell carcinoma:A systematic review and metaanalysis of retrospective studies

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Asian Journal of Urology 2021年第1期8卷 117-125页

作者： Yucong Zhang Gongwei Long Haojie Shang Beichen Ding Guoliang Sun Wei Ouyang Man Liu Yuan Chen Heng Li Hua Xu Zhangqun Ye Department of Urology Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina Hubei Institute of Urology Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina Department of Geriatrics Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina

Objective:To conduct a meta-analysis assessing the perioperative,functional and oncological outcomes of partial nephrectomy(PN)and radical nephrectomy(RN)for T1b *** primary endpoints were the oncological *** secondary endpoints were the perioperative and functional ***:A systematic literature review was performed by searching multiple databases through February 2019 to identify eligible comparative studies according to the Preferred Reporting Items for Systematic Review and Meta-analysis *** reports were assessed according to the Newcastle-Ottawa Scale for nonrandomized controlled ***:Overall,13 retrospective cohort studies were included in the *** undergoing PN were younger(weighted mean difference[WMD]3.49 years,95%confidence interval[CI]5.16 to1.82;p<0.0001)and had smaller masses(WMD0.45 cm,95%CI0.59 to0.31;p<0.0001).There were no differences in the oncological outcome,which was demonstrated by progression-free survival(hazard ratio[HR]0.70;pZ0.22),cancerspecific mortality(HR 0.91;pZ0.57)and all-cause mortality(HR 1.01;pZ0.96).The two procedures were similar in estimated blood loss(WMD16.47 mL;pZ0.53)and postoperative complications(risk ratio[RR]1.32;pZ0.10),and PN provided better renal function preservation and was related to a lower likelihood of chronic kidney disease onset(RR 0.38;pZ0.006).Conclusion:PN is an effective treatment for T1b tumours because it offers similar surgical morbidity,equivalent cancer control,and better renal preservation compared to RN.

关键词： Kidney cancer partial nephrectomy Radical nephrectomy Renal cancer Survival Renal function

Transcatheter embolization for hemorrhage from aberrant testicular artery after partial nephrectomy:A case report

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World Journal of Clinical Cases 2023年第32期11卷 7852-7857页

作者： Juyoun Youm Min-Jeong Choi Bong Man Kim Yumi Seo Department of Radiology Dankook University HospitalCheonan 31116South Korea Department of Urology Dankook University HospitalCheonan 31116South Korea

BACKGROUND Arterial bleeding typically involves the renal artery following partial nephrectomy;in this study,we present a case of bleeding originating from the testicular artery that has not been reported in previous *** SUMMARY A 52-year-old man suffered hemorrhage from a perinephric branch of the aberrant left testicular artery after an open nephron-sparing surgery for renal cell *** signs of bleeding were manifested by the patient,such as fresh blood drainage from the catheter,decreased hemoglobin levels,and significant vital sign *** computed tomography did not show evidence of active bleeding,transcatheter angiography was conducted to identify the bleeding *** spot images confirmed bleeding derived from a perinephric branch of the testicular artery originating from the segmental artery of the left renal *** n-butyl-2-cyanoacrylate,successful transcatheter arterial embolization of the affected branch was *** after the embolization procedure,the bleeding ceased,and the patient experienced complete recovery devoid of *** In patients with postoperative arterial hemorrhage after partial nephrectomy,the testicular artery can be a rare but notable source of *** bleeding site localization via angiographic evaluation,followed by transcatheter arterial embolization,can be instrumental for safe,prompt,and effective hemostasis.

关键词： partial nephrectomy Hemorrhage Testicular artery Angiography Embolization Case report

Current strategies to diagnose and manage positive surgical margins and local recurrence after partial nephrectomy

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Asian Journal of Urology 2022年第3期9卷 227-242页

作者： Umberto Carbonara Daniele Amparore Cosimo Gentile Riccardo Bertolo Selcuk Erdem Alexandre Ingels Michele Marchioni Constantijn H.J.Muselaers Onder Kara Laura Marandino Nicola Pavan Eduard Roussel Angela Pecoraro Fabio Crocerossa Giuseppe Torre Riccardo Campi Pasquale Ditonno European Association of Urology(EAU) Young Academic Urologists(YAU)Renal Cancer Working Group Department of Emergency and Organ Transplantation-Urology Andrology and Kidney Transplantation UnitUniversity of BariBariItaly Division of Urology Department of OncologySchool of MedicineSan Luigi HospitalUniversity of TurinOrbassanoTurinItaly Department of Urology San Carlo Di Nancy HospitalRomeItaly Division of Urologic Oncology Department of UrologyIstanbul University Istanbul Faculty of MedicineIstanbulTurkey Department of Urology University Hospital Henri MondorAPHPCreteilFrance Department of Urology SS Annunziata Hospital"G.D’Annunzio"University of ChietiChietiItaly Department of Urology Radboud University Medical CenterNijmegenthe Netherlands Department of Urology Kocaeli University School of MedicineKocaeliTurkey Department of Medical Oncology IRCCS Ospedale San RaffaeleVita-Salute San Raffaele UniversityMilanItaly Urology Clinic Department of MedicalSurgical and Health ScienceUniversity of TriesteTriesteItaly Department of Urology University Hospitals LeuvenLeuvenBelgium Department of Urology Magna Graecia University of CatanzaroCatanzaroItaly Unit of Urological Robotic Surgery and Renal Transplantation University of FlorenceCareggi HospitalFlorenceItaly

Objective:No standard strategy for diagnosis and management of positive surgical margin(PSM)and local recurrence after partial nephrectomy(PN)are reported in *** review aims to provide an overview of the current strategies and further perspectives on this patient ***:A non-systematic review of the literature was *** research included the most updated articles(about the last 10 years).Results:Techniques for diagnosing PSMs during PN include intraoperative frozen section,imprinting cytology,and other specific *** clear evidence is reported about these *** PSM management,active surveillance with a combination of imaging and laboratory evaluation is the first option line followed by *** local recurrence management,surgery is the primary curative approach when possible but it may be technically difficult due to anatomy resultant from previous *** this scenario,thermal ablation(TA)may have the potential to circumvent these limitations representing a less invasive *** surgery represents a valid option;six studies analyzed the outcomes of nephrectomy on local recurrence after PN with three of these focused on robotic ***all,complication rates of salvage surgery are higher compared to TA but ablation presents a higher recurrence rate up to 25%of cases that can often be managed with repeat ***:Controversy still exists surrounding the best strategy for management and diagnosis of patients with PSMs or local recurrence after *** surveillance is likely to be the optimal first-line management option for most patients with *** and salvage surgery both represent valid options in patients with local recurrence after ***,salvage PN and radical nephrectomy have fewer recurrences but are associated with a higher complication rate compared to *** this scenario,robotic surgery plays an important role in improving salvage PN and radical nephrectom

关键词： Positive surgical margin Local recurrence partial nephrectomy Radical nephrectomy Robot-assisted partial nephrectomy

The application of internal suspension technique in retroperitoneal robot-assisted laparoscopic partial nephrectomy with a new robotic system KangDuo Surgical Robot-01:Initial experience

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Asian Journal of Urology 2023年第4期10卷 482-487页

作者： Silu Chen Shubo Fan Hua Guan Kunlin Yang Zhihua Li Shengwei Xiong Xiang Wang Zhenyu Li Cheng Shen Liqun Zhou Xuesong Li Department of Urology Peking University First HospitalInstitute of UrologyPeking UniversityNational Urological Cancer CenterXicheng DistrictBeijingChina

Objective To assess the feasibility of internal suspension technique in retroperitoneal robot-assisted laparoscopic partial nephrectomy(rRAPN)with a new robotic platform called KangDuo Surgical Robot-01(KD-SR-01)system(Suzhou KangDuo Robot Co.,Ltd.,Suzhou,China)and discuss its surgical *** A 44-year-old male patient was admitted with a 2.5 cm tumor on dorsolateral upper pole of the left *** *** score of this patient was *** patient underwent rRAPN with *** perinephric fat between the tumor and Gerota's fascia was preserved,which was used for internal suspension traction during tumor *** follow-up data were *** The surgery was successfully carried out with a duration of 127 min,in which the docking time was 6 min 25 s and console time was 60 *** warm ischemia time was 19 min 53 s,and the estimated blood loss was 0 *** pathological histology showed a pathological tumor stage 1a clear cell renal cell carcinoma,with a negative surgical *** World Health Organization/International Society of Urological Pathology(WHO/ISUP)grade of this patient was Grade *** recurrence was observed during the 6-month *** Internal suspension in rRAPN is feasible and effective with use of the new robotic system KD-SR-01.

关键词： KangDuo Surgical Robot-01 Internal suspension partial nephrectomy Retroperitoneal approach

Open partial nephrectomy in Solitary Kidney with Multiple Renal Cell Carcinoma: a Case Report

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Chinese Medical Sciences Journal 2011年第4期26卷 249-250页

作者： Ji-rui Niu Quan-zong Mao Zhi-gang Ji Departments of Urology Peking Union Medical College Hospital Chinese Academy of Medical Sciences ＆ Peking Union Medical College Beijing 100730 China

ENAL cell carcinoma （RCC） in a solitary kidney presents a unique clinical challenge to urological surgeons. partial nephrectomy （PN） or nephron-sparing surgery in this condition provides good oncological and renal fuctional outcomes with an acceptable complication rate.1＇ 2 Long-term renal function remains stable in most patients with solitary kidneys after a reduction of more than 50% in renal mass.

关键词： solitary kidney partial nephrectomy renal function

Absence of asymptomatic unruptured renal artery pseudoaneurysm on contrast-enhanced computed tomography after robot-assisted partial nephrectomy without parenchymal renorrhaphy

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Asian Journal of Urology 2020年第1期7卷 24-28页

作者： Yoichiro Tohi Shiori Murata Noriyuki Makita Issei Suzuki Masashi Kubota Yoshio Sugino Koji Inoue Hiroyuki Ueda Mutsushi Kawakita Department of Urology Kobe City Medical Center General Hospital2-1-1 Minatojimaminami-choChuo-kuKobe CityJapan Department of Diagnostic Radiology Kobe City Medical Center General Hospital2-1-1 Minatojimaminami-choChuo-kuKobe CityJapan

Objective:To assess the incidence of asymptomatic unruptured renal artery pseudoaneurysm(RAP)on contrast-enhanced computed tomography(CE-CT)after robot-assisted partial nephrectomy(RAPN)without parenchymal ***:From May 2016 to December 2017,78 patients underwent RAPN for renal *** suture was performed in the opened collecting system or renal sinus,whereas parenchymal renorrhaphy was *** hemostasis,the soft coagulation system was used,and absorbable hemostats were placed on the resection ***-CT was carried out within 7 days after *** on these patients were prospectively collected.A single radiologist determined the diagnosis of ***:Median(range)data were as follows:Patient age,65(19-82)years;radiographic tumor size,30(12-95)mm;operating time,166(102-294)min;warm ischemic time,16(7-67)min;and blood loss,15(0-4450)*** patient(1.6%)required a perioperative blood *** patient required conversion to open surgery or ***-CT was carried out at median 6(3-7)days after ***-CT showed no RAP development in all 61 *** leakage was not *** patient had acute cholecystitis,a postoperative complication classified as Clavien-Dindo grade higher than 3,which was treated with *** surgical margin was identified in four patients(6.6%).Conclusion:RAPN using soft coagulation and absorbable hemostats without renorrhaphy appears to be feasible and *** technique could eliminate the risk of RAP.

关键词： Pseudoaneurysm partial nephrectomy Robot-assisted Renorrhaphy

Will not bagging an excised tumour immediately during partial nephrectomy possibly result in tumour seeding?A case report

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Laparoscopic, Endoscopic and Robotic Surgery 2022年第3期5卷 128-130页

作者： Xin Ling Teo Han Jie Lee Sey Kiat Lim Department of Urology Changi General Hospital2 Simei Street 3529889Singapore

partial nephrectomy is now a standard approach for small renal masses and tumour recurrences after partial nephrectomy are *** the absence of spillage,port site recurrences are most commonly *** report a case of tumour recurrence near the surgical site as well as beyond the posterior renal fascia and Gerotas fascia in a 60-year-old woman who underwent robot-assisted partial ne-phrectomy for a 4.6 cm suspicious left renal tumour despite the absence of gross tumour spillage or rupture *** showed a 5 cm clear cell renal cell carcinoma with negative surgical margins,nuclear grade 4 with focal malignant rhabdoid *** practice of not bagging the specimen immediately after tumour excision especially for higher risk tumours should be reviewed as there may be inadvertent microscopic spillage of tumour cells.

关键词： Tumour seeding Tumour recurrence partial nephrectomy