Abstract:
OBJECTIVE:• To compare outcomes of hilar clamping and non-hilar clamping partial nephrectomy for tumours involving a solitary functional kidney. PATIENTS AND METHODS:• Between 1990 and 2009, 104 partial nephrectomies, excluding bench and autotransplant procedures, were performed on solitary functional kidneys. • An institutional review board-approved retrospective review was performed analyzing patient demographics, operative data, complications, oncological outcomes and estimated glomerular filtration rate (GFR). • GFR was calculated using the abbreviated Modification of Diet in Renal Disease equation. • Preoperative GFR was compared to Early GFR (lowest measured GFR 7-100 days postoperatively) and to Late GFR (GFR 101-365 days postoperatively). • Multiple linear regression analysis was performed to assess covariates affecting Late GFR. • Kaplan-Meier estimator was utilized to compare renal cell carcinoma (RCC) specific survival and non-RCC-related survival. RESULTS:• In total, 29 partial nephrectomies with hilar clamping and 75 partial nephrectomies without hilar clamping were performed in solitary kidneys. Median follow-up was 57 months. • There was no difference in tumour size, location and the number of tumours resected between the two groups. Mean ischaemia time for the clamping group was 25 min. • Some 97% of the clamping procedures were performed with cold ischaemia. • There was no difference in intra-operative estimated blood loss, transfusion requirement or length of hospital stay. • The complication rate and spectrum of complications were similar between the two groups. • The two groups had similar preoperative GFR and Early GFR. The non-clamping group had a significantly smaller percent decrease in Late GFR (11.8% vs 27.7%, P= 0.01) than the clamping group. • The non-clamping group was significantly more likely to have a less than 10% decrease in Late GFR compared to the clamping group (60.9% vs 17.7%, P= 0.002). • On multivariate analysis, only hilar clamping was significantly associated with decreased Late GFR (estimate 15.0, P= 0.02). • Surgical margin positivity rate was higher in the clamping group (21% vs 4%, P= 0.01); however, the local recurrence rate between the two groups was similar. • The clamping and non-clamping groups had similar 5-year RCC-specific survival and 5-year non-RCC-related survival. CONCLUSIONS:• Partial nephrectomy without hilar clamping in solitary kidneys provides similar cancer control compared to partial nephrectomy with hilar clamping. • Partial nephrectomy without clamping was associated with superior preservation of Late GFR. • No difference was detected in GFR early after surgery, possibly indicating that there may be ongoing renal loss after hilar clamping.
journal_name
BJU Intjournal_title
BJU internationalauthors
Wszolek MF,Kenney PA,Lee Y,Libertino JAdoi
10.1111/j.1464-410X.2010.09713.xsubject
Has Abstractpub_date
2011-06-01 00:00:00pages
1886-92issue
12eissn
1464-4096issn
1464-410Xjournal_volume
107pub_type
杂志文章abstract:OBJECTIVE:To evaluate the experience and views regarding live surgical broadcasts (LSB) among European urologists attending the European Association of Urology Robotic Urology Society (ERUS) congress in September 2012. MATERIALS AND METHODS:An anonymous survey was distributed via email inviting the participants of the...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/bju.12283
更新日期:2014-07-01 00:00:00
abstract:OBJECTIVE:To evaluate the prevalence of depression, anxiety and distress among active surveillance (AS) and radical prostatectomy (RP) patients. To evaluate the impact of these symptoms at baseline on urinary and sexual quality of life at follow-up. PATIENTS AND METHODS:Patients managed with AS or RP who completed val...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/bju.12209
更新日期:2013-07-01 00:00:00
abstract:UNLABELLED:What's known on the subject? and What does the study add? There appears to be a clear difference in cancer control outcomes for patients with Gleason scores of 3+4 and those with scores of 4+3 after radical prostatectomy. It has been documented that patients with Gleason 4+3 prostate cancer have higher incid...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2012.11057.x
更新日期:2012-11-01 00:00:00
abstract:OBJECTIVE:•To evaluate the natural history of patients presenting with positive urinary cytology in the absence of clinically identifiable disease. PATIENTS AND METHODS:•A surgical database was queried to identify 48 patients with positive urinary cytology of undetermined source. •All patients underwent a thorough uro...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2011.10210.x
更新日期:2011-10-01 00:00:00
abstract:OBJECTIVES:To compare the results of retroperitoneal laparoscopic with open partial nephroureterectomy. PATIENTS AND METHODS:Laparoscopic retroperitoneal partial nephroureterectomy was undertaken in 15 children (13 upper and two lower poles; median age at the time of surgery 61 months, range 5-212). A three-trocar ret...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1046/j.1464-410x.2003.04126.x
更新日期:2003-04-01 00:00:00
abstract::To assess the evidence for the concept that the androgen receptor of prostate cancer (PCa) cells becomes saturated when testosterone values exceed castrate levels, so that testosterone administration in hypogonadal men with untreated PCa does not stimulate tumour growth. To propose basic criteria for administration of...
journal_title:BJU international
pub_type: 杂志文章,评审
doi:10.1111/j.1464-410X.2011.10193.x
更新日期:2011-05-01 00:00:00
abstract:OBJECTIVES:To evaluate the effects of 50 mg mirabegron once daily for ureteric stent-related discomfort after ureteroscopic procedures by conducting a multicentre randomized study. PATIENTS AND METHODS:A total of 100 patients with indwelling ureteric stents after ureteroscopic stone removal or retrograde intrarenal su...
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pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1111/bju.14416
更新日期:2018-11-01 00:00:00
abstract:OBJECTIVE:To assess the effect of antimuscarinic treatment with tolterodine combined with behavioural modification as a first-line treatment, before invasive investigation, in children with non-neurogenic voiding dysfunction but no obvious anatomical or neurogenic cause. PATIENTS AND METHODS:The study comprised 44 chi...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2005.05641.x
更新日期:2005-08-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2010.09695.x
更新日期:2011-05-01 00:00:00
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pub_type: 杂志文章
doi:10.1111/j.1464-410X.2011.10526.x
更新日期:2012-04-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1046/j.1464-410x.2001.02212.x
更新日期:2001-06-01 00:00:00
abstract:UNLABELLED:What's known on the subject? and What does the study add? Positive surgical margins (PSMs) after radical prostatectomy are common, although their impact on the risk of disease recurrence is unknown. We examined the impact of PSMs on the risk of 'significant' biochemical recurrence stratified by their risk of...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2011.10868.x
更新日期:2012-09-01 00:00:00
abstract:OBJECTIVE:To determine, using a postal questionnaire survey of practising British consultant urologists, the duration and type of antibiotic deemed most effective in patients with an existing indwelling catheter before transurethral resection of the prostate (TURP), as the value of prophylactic antibiotics before TURP ...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1046/j.1464-410x.2003.04429.x
更新日期:2003-10-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2008.07558.x
更新日期:2008-08-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1464-410x.2003.04609.x
更新日期:2004-02-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1464-410X.2010.09636.x
更新日期:2011-05-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1046/j.1464-410x.1999.00151.x
更新日期:1999-07-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2008.07909.x
更新日期:2008-12-01 00:00:00
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pub_type: 杂志文章
doi:10.1111/bju.14695
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pub_type: 杂志文章
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更新日期:1999-02-01 00:00:00
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更新日期:2005-06-01 00:00:00
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journal_title:BJU international
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1111/j.1464-410X.2004.04768.x
更新日期:2004-05-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/bju.12446
更新日期:2014-05-01 00:00:00
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pub_type: 杂志文章
doi:10.1111/bju.13972
更新日期:2018-01-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章,meta分析,评审
doi:10.1111/j.1464-410X.2008.07496.x
更新日期:2008-03-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2012.11484.x
更新日期:2012-12-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2009-04-01 00:00:00
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journal_title:BJU international
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1046/j.1464-410x.1999.00028.x
更新日期:1999-05-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2009.09032.x
更新日期:2010-06-01 00:00:00
abstract::To analyse studies validating the effectiveness of robotic surgery simulators. The MEDLINE(®), EMBASE(®) and PsycINFO(®) databases were systematically searched until September 2011. References from retrieved articles were reviewed to broaden the search. The simulator name, training tasks, participant level, training d...
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pub_type: 杂志文章,评审
doi:10.1111/j.1464-410X.2012.11270.x
更新日期:2013-02-01 00:00:00