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Off‐clamp tumor excision using soft coagulation in laparoscopic and robotic partial nephrectomy
Author(s) -
Yoshida Tetsuya,
Okinaka Yuki,
Tomita Keiji,
Tsuru Teruhiko,
Kageyama Susumu,
Narita Mitsuhiro,
Kawauchi Akihiro
Publication year - 2020
Publication title -
asian journal of endoscopic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.372
H-Index - 18
eISSN - 1758-5910
pISSN - 1758-5902
DOI - 10.1111/ases.12775
Subject(s) - medicine , nephrectomy , surgery , perioperative , hemostasis , coagulation , clamp , kidney , clamping , mechanical engineering , engineering
The aim of this study was to assess the perioperative outcomes of off‐clamp tumor excision using soft coagulation in laparoscopic and robotic partial nephrectomy. Methods We retrospectively analyzed the data from 78 patients who underwent minimally invasive partial nephrectomy, using soft coagulation, at the Shiga University of Medical Science, between September 2013 and April 2017. Tumor excision and hemostasis without renal arterial clamping was performed using soft coagulation. Collecting system repair and renorrhaphy with arterial clamping were carried out only if the collecting system had been opened. Results Forty‐three of the 78 patients underwent laparoscopic partial nephrectomy using soft coagulation and the other 35 patients underwent robotic partial nephrectomy using soft coagulation. The median estimated total blood loss was 73 (0‐1140) mL and no patient needed a blood transfusion. No cases featured postoperative hemorrhagic events. Six patients with urinary fistula needed prolonged ureteral stenting. The median percentage change of the estimated glomerular filtration rate was −7.2 at one to 3 months after surgery. Conclusion The off‐clamp soft coagulation technique in laparoscopic partial nephrectomy and robotic partial nephrectomy is a safe and feasible approach to excise kidney tumors. This procedure may reduce the incidence of perioperative hemorrhagic complications.