PD29-04 HISPANO-AMERICAN EXPERIENCE IN MINIMALLY INVASIVE PARTIAL NEPHRECTOMY
2015; Lippincott Williams & Wilkins; Volume: 193; Issue: 4S Linguagem: Inglês
10.1016/j.juro.2015.02.1791
ISSN1527-3792
AutoresFernando P. Secín, Octavio Castillo Cádiz, Patricio Aitor García Marchiñena, Alberto Jurado Navarro, Agustín Roberto Rovegno, Anamaría Autrán, Ó. Rodríguez Faba, Joan Palou Redorta, J. Rozanec, Marcelo Featherstone, Pablo Holst, Luciano Nuñez Bragayrac, René Sotelo, Ricardo Faveretto, Stênio de Cássio Zéqui, Mario Álvarez‐Maestro, Luis Martínez‐Piñeiro, Gustavo Villoldo, Alberto Villaronga, Diego Abreu Clavijo, Ivar Vidal Mora, Diana Finkelstein, Juan Ignacio Monzó Gardiner, Oscar Schatloff, Andrés Hernández Porras, Félix Santaella Torres, Rodolfo Sanchez Salas, Hugo Dávila, H. Villavicencio Mavrich,
Tópico(s)Ethics and bioethics in healthcare
ResumoYou have accessJournal of UrologyKidney Cancer: Surgical Therapy I1 Apr 2015PD29-04 HISPANO-AMERICAN EXPERIENCE IN MINIMALLY INVASIVE PARTIAL NEPHRECTOMY Fernando Pablo Secin, Octavio Castillo Cadiz, Patricio Aitor García Marchiñena, Alberto Jurado Navarro, Agustin Rovegno, Anamaria Autran, Oscar Rodriguez Faba, Joan Palou Redorta, Jose Rozanec, Marcelo Featherstone, Pablo Holst, Luciano Nuñez Bragayrac, Rene Sotelo, Ricardo Faveretto, Stenio Zequi, Mario Álvarez Maestro, Luis Martinez Piñeiro, Gustavo Villoldo, Alberto Villaronga, Diego Abreu Clavijo, Ivar Vidal Mora, Diana Finkelstein, Juan Ignacio Monzo Gardiner, Oscar Schatloff, Andres Hernandez Porras, Félix Santaella Torres, Rodolfo Sanchez Salas, Hugo Alberto Davila, and Humberto Villavicencio Mavrich Fernando Pablo SecinFernando Pablo Secin More articles by this author , Octavio Castillo CadizOctavio Castillo Cadiz More articles by this author , Patricio Aitor García MarchiñenaPatricio Aitor García Marchiñena More articles by this author , Alberto Jurado NavarroAlberto Jurado Navarro More articles by this author , Agustin RovegnoAgustin Rovegno More articles by this author , Anamaria AutranAnamaria Autran More articles by this author , Oscar Rodriguez FabaOscar Rodriguez Faba More articles by this author , Joan Palou RedortaJoan Palou Redorta More articles by this author , Jose RozanecJose Rozanec More articles by this author , Marcelo FeatherstoneMarcelo Featherstone More articles by this author , Pablo HolstPablo Holst More articles by this author , Luciano Nuñez BragayracLuciano Nuñez Bragayrac More articles by this author , Rene SoteloRene Sotelo More articles by this author , Ricardo FaverettoRicardo Faveretto More articles by this author , Stenio ZequiStenio Zequi More articles by this author , Mario Álvarez MaestroMario Álvarez Maestro More articles by this author , Luis Martinez PiñeiroLuis Martinez Piñeiro More articles by this author , Gustavo VilloldoGustavo Villoldo More articles by this author , Alberto VillarongaAlberto Villaronga More articles by this author , Diego Abreu ClavijoDiego Abreu Clavijo More articles by this author , Ivar Vidal MoraIvar Vidal Mora More articles by this author , Diana FinkelsteinDiana Finkelstein More articles by this author , Juan Ignacio Monzo GardinerJuan Ignacio Monzo Gardiner More articles by this author , Oscar SchatloffOscar Schatloff More articles by this author , Andres Hernandez PorrasAndres Hernandez Porras More articles by this author , Félix Santaella TorresFélix Santaella Torres More articles by this author , Rodolfo Sanchez SalasRodolfo Sanchez Salas More articles by this author , Hugo Alberto DavilaHugo Alberto Davila More articles by this author , and Humberto Villavicencio MavrichHumberto Villavicencio Mavrich More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1791AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES There is scant information on results of minimally invasive partial nephrectomy (PN) in Hispanic-America. Our aim was to describe the perioperative and oncology outcomes in a series of laparoscopic or robotic PNs for renal tumors treated in 16 centers of Hispanic-America from 1/1992-8/2014. METHODS A data base including clinical, surgical and outcome information was submitted to the collaborating institutions. We estimated proportions, medians, 95% confidence intervals, Kaplan Meier curves, logistic and Cox regression analyses to explore variables associated with complications and recurrence. Clavien classification was used to tabulate complications. The study has been performed under the scope of the American Confederation of Urology (CAU). RESULTS We evaluated 1034 laparoscopic or robotic PNs. Median age: 58 years, with a 2:1 male to female ratio. 97% was carried out via purely laparoscopic and 83% by a trans peritoneal approach. Median surgical time: 150 minutes, with warm ischemia time of 20 minutes and intraoperative bleeding of 150cc. 80% of the lesions were malignant, with clear cell histology being 62.4% of the total. The median maximum tumour diameter was 2.8 cm. with a positive margins rate of 7.5%. Median hospitalization: 3 days. The overall complication rate was 21%; Clavien (C) 1: 5%; C 2: 10%; C 3A: 1.43%; C 3B: 3.8%; C 4A: 0.82% and C 4B: 0.2%. There were no reported deaths. Bleeding and urinary fistula were the main causes of re operation. Transfusion rate: 13%. Bleeding was the main cause of conversion to radical nephrectomy (1.5%) and conversion to open partial nephrectomy (2.8%). In multivariate analysis, maximum tumour diameter, (p: 0.011) and the presence of two or more tumours in the same renal unit (p< 0.001) were significantly associated with greater likelihood of complications. Nineteen patients presented recurrence and or progression of the disease in a median follow-up of 22.8 months. The local or distant 5-year progression free rate was 93% (95%CI:89,96). The corresponding cancer specific and overall survival was 99% (95%CI: 98,100) and 98 %(95%CI:96,99), respectively. Females (p:0.005), presence of bilateral tumours (p:0.004), need for reoperation (p 0.003) and the presence of positive margin (p 0.003) were significantly associated with a greater likelihood of disease recurrence and or progression. CONCLUSIONS Laparoscopic PN with or without robotic assistance in these centres of Hispanic America have perioperative outcomes, complications and 5-year progression free rates similar to those published in other parts of the world. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e649-e650 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Fernando Pablo Secin More articles by this author Octavio Castillo Cadiz More articles by this author Patricio Aitor García Marchiñena More articles by this author Alberto Jurado Navarro More articles by this author Agustin Rovegno More articles by this author Anamaria Autran More articles by this author Oscar Rodriguez Faba More articles by this author Joan Palou Redorta More articles by this author Jose Rozanec More articles by this author Marcelo Featherstone More articles by this author Pablo Holst More articles by this author Luciano Nuñez Bragayrac More articles by this author Rene Sotelo More articles by this author Ricardo Faveretto More articles by this author Stenio Zequi More articles by this author Mario Álvarez Maestro More articles by this author Luis Martinez Piñeiro More articles by this author Gustavo Villoldo More articles by this author Alberto Villaronga More articles by this author Diego Abreu Clavijo More articles by this author Ivar Vidal Mora More articles by this author Diana Finkelstein More articles by this author Juan Ignacio Monzo Gardiner More articles by this author Oscar Schatloff More articles by this author Andres Hernandez Porras More articles by this author Félix Santaella Torres More articles by this author Rodolfo Sanchez Salas More articles by this author Hugo Alberto Davila More articles by this author Humberto Villavicencio Mavrich More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
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