Partial nephrectomy (NP) after embolization of tumor vessels (NPESH) in a hybrid room combines embolization of tumor vessels and enucleation of the tumor under laparoscopy in the same operative time. The purpose of this study was to assess the impact of the use of NPESH in the management of patients treated with surgery for a localized kidney tumor.
Using the uroCCR database, we included all consecutive patients operated in a university hospital for localized kidney tumor. From 2011 to May 2015, patients were treated by Standard Partial Nephrectomy (NPS) Laparoscopic or Open and from May 2015 to May 2019 by NPESH. We evaluated characteristics of patients, tumors, perioperative data and complications. These data were compared by Student and Khi2 tests.
87 NPS were performed during Period 1 and 137 NPS were performed during period 2. The ASA score of patients undergoing NPESH was higher than NPS (P<0.0001). The tumor complexity and median tumor size were similar in the two groups (P=0.852 and P=0.48). The complication rate for NPS and NPESH was 55.2% and 33.6% (P=0.002). There were less severe complications in the NEPSH group (P=0.012). The median length of stay was 8 and 4 days for the NPS and NPESH groups (P<0.0001). Positive surgical margins were 2 (2.3%) and 6 (4.6%) for the NPS and NPESH group (P=0.713).
NPESH is an efficient technique compared to NPS. It seems to be an interesting alternative to limit renal ischemia, complication rate and length of stay for the management of localized kidney tumors.
Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie. 2020 Mar 28 [Epub ahead of print]
C Aubert, C Rolley, M Mauny, J Heuveline, E Silve, M Humeau, V Le Corre, S Lebdai, E Brassart, T Culty, N Baize, M C Rousselet, C Nedelcu, C Aubé, A Bouvier, P Bigot
Service d'urologie, CHU de Angers, 4, rue Larrey, 49933 Angers cedex 9, France., UTTIOM, unité transversale de thérapeutiques innovantes en oncologie médicale, CHU de Angers, 4, rue Larrey, 49933 Angers, France., Faculté de médecine d'Angers, 49000 Angers, France., Département d'anatomopathologie, CHU de Angers, 4, rue Larrey, 49933 Angers, France., Service de radiologie, CHU de Angers, 4, rue Larrey, 49933 Angers, France., Service d'urologie, CHU de Angers, 4, rue Larrey, 49933 Angers cedex 9, France. Electronic address: .