Recommendations and optimal approaches to robotic-assisted partial nephrectomy: A consensus of Brazilian experts

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article
Data de publicação
2023
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Scopus
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Editora
FRONTIERS MEDIA SA
Autores
FARIA, E. F.
MOSCHOVAS, M. C.
VAZ, C.
POMPEO, A.
SANTOS, A.
STIEVANO, A.
BERGER, A.
CARNEIRO, A.
DOURADO, A.
COLOMBO, J. R.
Citação
FRONTIERS IN UROLOGY, v.3, article ID 1119494, p, 2023
Projetos de Pesquisa
Unidades Organizacionais
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Resumo
Objective: Robotic-assisted partial nephrectomy (RAPN) is established as the gold standard approach to treating small renal masses. However, numerous technical challenges and concepts related to this approach are still under discussion and are not consensus among surgeons from different centers. We performed an online questionnaire with multiple topics about RAPN and selected high-volume surgeons from referral centers in Brazil to achieve a consensus. Methods: We implemented an online consensus of 29 experts selected based on surgical expertise and competence in analyzing the published literature. Based on the collected literature and current Guidelines (NCCN, AUA, and EAU) we created a questionnaire with 131 questions and administered it to all participants. The statements and the Delphi technique design were combined in a single round of questions. The answers were reviewed, 70% of concordance was considered a consensus, and a final manuscript with recommendations was developed. Results: We divided our results into 25 subtopics that included all questions and discussions of the questionnaire, including preoperative settings, surgical technique, pathological analysis, technology use, and challenging cases. Some areas had limited data in the literature, and these potential limitations were addressed and discussed on each topic. Conclusion: RAPN is the standard surgical treatment for renal masses in the centers of robotic surgery. Among the important topics of this study, we recommend always performing the first RAPN cases with proctors’ assistance, conducting preoperative planning using good-quality imaging exams, minimizing the amount of renal parenchyma removed, and achieving appropriate hemostatic suture while reducing renal parenchyma ischemia.
Palavras-chave
kidney, kidney cancer, nephrectomy, partial nephrectomy, robotic surgery
URI
https://observatorio.fm.usp.br/handle/OPI/58668
Referências
  1. Bukavina L., Mishra K., Calaway A., Ponsky L., Robotic partial nephrectomy: Update on techniques, Urol Clin North Am, 48, 1, pp. 81-90, (2021)
  2. Fink A., Kosecoff J., Chassin M., Brook R.H., Consensus methods: characteristics and guidelines for use, Am J Public Health, 74, 9, (1984)
  3. Sugihara T., Yasunaga H., Horiguchi H., Fujimura T., Nishimatsu H., Ohe K., Et al., Does mechanical bowel preparation improve quality of laparoscopic nephrectomy? propensity score-matched analysis in Japanese series, Urology, 81, 1, (2013)
  4. Chi A.C., McGuire B.B., Nadler R.B., Modern guidelines for bowel preparation and antimicrobial prophylaxis for open and laparoscopic urologic surgery, Urol Clin North Am, 42, 4, (2015)
  5. Israel GNB M.A., Pitfalls in renal mass evaluation and how to avoid them, Radiographics, 28, (2008)
  6. Shao P., Tang L., Li P., Xu Y., Qin C., Cao Q., Et al., Precise segmental renal artery clamping under the guidance of dual-source computed tomography angiography during laparoscopic partial nephrectomy, Eur Urol, 62, 6, (2012)
  7. Ferda J., Hora M., Hes O., Ferdova E., Kreuzberg B., Assessment of the kidney tumor vascular supply by two-phase MDCT-angiography, Eur J Radiol, 62, 2, pp. 295-301, (2007)
  8. Defortescu G., Cornu J.N., Bejar S., Giwerc A., Gobet F., Werquin C., Et al., Diagnostic performance of contrast-enhanced ultrasonography and magnetic resonance imaging for the assessment of complex renal cysts: A prospective study, Int J Urol, 24, 3, (2017)
  9. Porpiglia F., Bertolo R., Checcucci E., Amparore D., Autorino R., Dasgupta P., Et al., Development and validation of 3D printed virtual models for robot-assisted radical prostatectomy and partial nephrectomy: urologists’ and patients’ perception, World J Urol, 36, 2, (2018)
  10. Antonelli A., Veccia A., Palumbo C., Peroni A., Mirabella G., Cozzoli A., Et al., Holographic reconstructions for preoperative planning before partial nephrectomy: A head-to-Head comparison with standard CT scan, Urol Int, 102, 2, (2019)
  11. Cacciamani G.E., Okhunov Z., Meneses A.D., Rodriguez-Socarras M.E., Rivas J.G., Porpiglia F., Et al., Impact of three-dimensional printing in urology: State of the art and future perspectives, A Systematic Rev by ESUT-YAUWP Group Eur Urol, 76, 2, (2019)
  12. Wake N., Bjurlin M.A., Rostami P., Chandarana H., Huang W.C., Three-dimensional printing and augmented reality: Enhanced precision for robotic assisted partial nephrectomy, Urology, 116, (2018)
  13. Walther M.M., Choyke P.L., Hayes W., Shawker T.H., Alexander R.B., Linehan W.M., Evaluation of color Doppler intraoperative ultrasound in parenchymal sparing renal surgery, J Urol, 152 Pt 1, (1994)
  14. Choyke P.L., Pavlovich C.P., Daryanani K.D., Hewitt S.M., Linehan W.M., Walther M.M., Intraoperative ultrasound during renal parenchymal sparing surgery for hereditary renal cancers: a 10-year experience, J Urol, 165, 2, pp. 397-400, (2001)
  15. Boris R., Proano M., Linehan W.M., Pinto P.A., Bratslavsky G., Initial experience with robot assisted partial nephrectomy for multiple renal masses, J Urol, 182, 4, (2009)
  16. Spaliviero M., Poon B.Y., Karlo C.A., Guglielmetti G.B., Di Paolo P.L., Beluco Corradi R., Et al., An arterial based complexity (ABC) scoring system to assess the morbidity profile of partial nephrectomy, Eur Urol, 69, 1, (2016)
  17. Ficarra V., Novara G., Secco S., Macchi V., Porzionato A., De Caro R., Et al., Preoperative aspects and dimensions used for an anatomical (PADUA) classification of renal tumours in patients who are candidates for nephron-sparing surgery, Eur Urol, 56, 5, (2009)
  18. Kutikov A., Uzzo R.G., The R.E.N.A.L. nephrometry score: a comprehensive standardized system for quantitating renal tumor size, location and depth, J Urol, 182, 3, (2009)
  19. Simmons M.N., Ching C.B., Samplaski M.K., Park C.H., Gill I.S., Kidney tumor location measurement using the c index method, J Urol, 183, 5, (2010)
  20. Davidiuk A.J., Parker A.S., Thomas C.S., Leibovich B.C., Castle E.P., Heckman M.G., Et al., Mayo Adhesive probability score: an accurate image-based scoring system to predict adherent perinephric fat in partial nephrectomy, Eur Urol, 66, 6, (2014)
  21. Veccia A., Antonelli A., Uzzo R.G., Novara G., Kutikov A., Ficarra V., Et al., Predictive value of nephrometry scores in nephron-sparing surgery: A systematic review and meta-analysis, Eur Urol Focus, 6, 3, pp. 490-504, (2020)
  22. Davidiuk A.J., Parker A.S., Thomas C.S., Heckman M.G., Custer K., Thiel D.D., Prospective evaluation of the association of adherent perinephric fat with perioperative outcomes of robotic-assisted partial nephrectomy, Urology, 85, 4, (2015)
  23. Haseebuddin M., Benway B.M., Cabello J.M., Bhayani S.B., Robot-assisted partial nephrectomy: evaluation of learning curve for an experienced renal surgeon, J Endourol, 24, 1, pp. 57-61, (2010)
  24. Faria E.F., Caputo P.A., Wood C.G., Karam J.A., Nogueras-Gonzalez G.M., Matin S.F., Robotic partial nephrectomy shortens warm ischemia time, reducing suturing time kinetics even for an experienced laparoscopic surgeon: a comparative analysis, World J Urol, 32, 1, (2014)
  25. Pavan N., Derweesh I., Hampton L.J., White W.M., Porter J., Challacombe B.J., Et al., Retroperitoneal robotic partial nephrectomy: Systematic review and cumulative analysis of comparative outcomes, J Endourol, 32, 7, (2018)
  26. Ray S., Cheaib J.G., Biles M.J., Pineault K.G., Johnson M.H., Ged Y.M.A., Et al., Local and regional recurrences of clinically localized renal cell carcinoma after nephrectomy: A 15 year institutional experience with prognostic features and oncologic outcomes, Urology, 154, (2021)
  27. Lane B.R., Gill I.S., 5-year outcomes of laparoscopic partial nephrectomy, J Urol, 177, 1, (2007)
  28. Shah P.H., Moreira D.M., Okhunov Z., Patel V.R., Chopra S., Razmaria A.A., Et al., Positive surgical margins increase risk of recurrence after partial nephrectomy for high risk renal tumors, J Urol, 196, 2, (2016)
  29. Minervini A., Ficarra V., Rocco F., Antonelli A., Bertini R., Carmignani G., Et al., Simple enucleation is equivalent to traditional partial nephrectomy for renal cell carcinoma: results of a nonrandomized, retrospective, comparative study, J Urol, 185, 5, (2011)
  30. Blackwell R.H., Li B., Kozel Z., Zhang Z., Zhao J., Dong W., Et al., Functional implications of renal tumor enucleation relative to standard partial nephrectomy, Urology, 99, (2017)
  31. Carini M., Minervini A., Masieri L., Lapini A., Serni S., Simple enucleation for the treatment of PT1a renal cell carcinoma: our 20-year experience, Eur Urol, 50, 6, (2006)
  32. Castilla E.A., Liou L.S., Abrahams N.A., Fergany A., Rybicki L.A., Myles J., Et al., Prognostic importance of resection margin width after nephron-sparing surgery for renal cell carcinoma, Urology, 60, 6, (2002)
  33. Ljungberg B., Cowan N.C., Hanbury D.C., Hora M., Kuczyk M.A., Merseburger A.S., Et al., EAU guidelines on renal cell carcinoma: the 2010 update, Eur Urol, 58, 3, pp. 398-406, (2010)
  34. Greco F., Autorino R., Altieri V., Campbell S., Ficarra V., Gill I., Et al., Ischemia techniques in nephron-sparing surgery: A systematic review and meta-analysis of surgical, oncological, and functional outcomes, Eur Urol, 75, 3, (2019)
  35. Carlos A.S., Nunes-Silva I., Zampolli H.C., Meyer F., Faria E.F., Tobias-Machado M., Laparoscopic partial nephrectomy without clamping the renal pedicle, Surg Endosc, 34, 7, (2020)
  36. Carlos A.S., Tobias-Machado M., Starling E.S., Correa de Araujo F.B., Faria E.F., Nogueira L., Et al., Alternative techniques to reduce warm ischemia time in laparoscopic partial nephrectomy, Int Braz J Urol, 39, 1, (2013)
  37. Rosen D.C., Kannappan M., Paulucci D.J., Beksac A.T., Attalla K., Abaza R., Et al., Reevaluating warm ischemia time as a predictor of renal function outcomes after robotic partial nephrectomy, Urology, 120, (2018)
  38. Simone G., Gill I.S., Mottrie A., Kutikov A., Patard J.J., Alcaraz A., Et al., Indications, techniques, outcomes, and limitations for minimally ischemic and off-clamp partial nephrectomy: a systematic review of the literature, Eur Urol, 68, 4, (2015)
  39. Krane L.S., Manny T.B., Hemal A.K., Is near infrared fluorescence imaging using indocyanine green dye useful in robotic partial nephrectomy: a prospective comparative study of 94 patients, Urology, 80, 1, (2012)
  40. Shatagopam K., Bahler C.D., Sundaram C.P., Renorrhaphy techniques and effect on renal function with robotic partial nephrectomy, World J Urol, 38, 5, (2020)
  41. Bertolo R., Campi R., Klatte T., Kriegmair M.C., Mir M.C., Ouzaid I., Et al., Suture techniques during laparoscopic and robot-assisted partial nephrectomy: a systematic review and quantitative synthesis of peri-operative outcomes, BJU Int, 123, 6, (2019)
  42. Hillyer S., Spana G., White M.A., Autorino R., Laydner H., Khanna R., Et al., Novel robotic renorrhaphy technique for hilar tumours: ‘V’ hilar suture (VHS), BJU Int, 109, 10, (2012)
  43. Kaygisiz O., Celen S., Vuruskan B.A., Vuruskan H., Comparison of two different suture techniques in laparoscopic partial nephrectomy, Int Braz J Urol, 43, 5, (2017)
  44. Porpiglia F., Bertolo R., Amparore D., Fiori C., Nephron-sparing suture of renal parenchyma after partial nephrectomy: Which technique to go for? some best practices, Eur Urol Focus, 5, 4, (2019)
  45. Ja G., The use of barbed sutures in obstetrics and gynecology, Rev In Obstetrics Gynecology, 3, (2010)
  46. Jeon S.H., Jung S., Son H.S., Kimm S.Y., Chung B.I., The unidirectional barbed suture for renorrhaphy during laparoscopic partial nephrectomy: Stanford experience, J Laparoendosc Adv Surg Tech A, 23, 6, (2013)
  47. Takeda T., Miyajima A., Kaneko G., Hasegawa M., Kikuchi E., Oya M., Unidirectional barbed suture for vesicourethral anastomosis during laparoscopic radical prostatectomy, Asian J Endosc Surg, 7, 3, (2014)
  48. Williams S.B., Alemozaffar M., Lei Y., Hevelone N., Lipsitz S.R., Plaster B.A., Et al., Randomized controlled trial of barbed polyglyconate versus polyglactin suture for robot-assisted laparoscopic prostatectomy anastomosis: technique and outcomes, Eur Urol, 58, 6, (2010)
  49. Tewari A.K., Srivastava A., Sooriakumaran P., Slevin A., Grover S., Waldman O., Et al., Use of a novel absorbable barbed plastic surgical suture enables a “self-cinching” technique of vesicourethral anastomosis during robot-assisted prostatectomy and improves anastomotic times, J Endourol, 24, 10, (2010)
  50. Zorn K.C., Trinh Q.D., Jeldres C., Schmitges J., Widmer H., Lattouf J.B., Et al., Prospective randomized trial of barbed polyglyconate suture to facilitate vesico-urethral anastomosis during robot-assisted radical prostatectomy: time reduction and cost benefit, BJU Int, 109, 10, (2012)
  51. Moran M.E., Marsh C., Perrotti M., Bidirectional-barbed sutured knotless running anastomosis v classic van velthoven suturing in a model system, J Endourol, 21, 10, (2007)
  52. Ng C.S., Gill I.S., Ramani A.P., Steinberg A.P., Spaliviero M., Abreu S.C., Et al., Transperitoneal versus retroperitoneal laparoscopic partial nephrectomy: patient selection and perioperative outcomes, J Urol, 174, 3, (2005)
  53. Klatte T., Wunderlich H., Patard J.J., Kleid M.D., Lam J.S., Junker K., Et al., Clinicopathological features and prognosis of synchronous bilateral renal cell carcinoma: an international multicentre experience, BJU Int, 100, 1, (2007)
  54. Wunderlich H., Schlichter A., Zermann D., Reichelt O., Kosmehl H., Schubert J., Multifocality in renal cell carcinoma: A bilateral event, Urol Int, 63, 3, (1999)
  55. Shuch B., Singer E.A., Bratslavsky G., The surgical approach to multifocal renal cancers: hereditary syndromes, ipsilateral multifocality, and bilateral tumors, Urol Clin North Am, 39, 2, (2012)
  56. Zargar H., Bhayani S., Allaf M.E., Stifelman M., Rogers C., Larson J., Et al., Comparison of perioperative outcomes of robot-assisted partial nephrectomy and open partial nephrectomy in patients with a solitary kidney, J Endourol, 28, 10, (2014)
  57. Komninos C., Shin T.Y., Tuliao P., Kim D.K., Han W.K., Chung B.H., Et al., Robotic partial nephrectomy for completely endophytic renal tumors: complications and functional and oncologic outcomes during a 4-year median period of follow-up, Urology, 84, 6, (2014)

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Artigos e Materiais de Revistas Científicas - HC/ICESP
Artigos e Materiais de Revistas Científicas - LIM/55
Artigos e Materiais de Revistas Científicas - ODS/03