Purpose: The aim of this study is to describe our experience in laparoscopic partial nephrectomy and to compare the differences between off-clamp and on-clamp techniques in terms of clinical characteristics and outcomes.

Methods: A retrospective study was utilized. A purposeful sampling method was used to select the patients. The inclusion criteria for kidney tumors were as follows: exophytic, maximum diameter 3 cm, RENAL score 4 or more, solid or cystic, and suspected of malignancy. Around 32 participants were selected. The data were collected from patient files.

Results: There were no statistically significant differences between the mean of the off-clamp group and the on-clamp group in terms of tumor size, size of the kidney, and the position of the tumor. The average expected blood loss in the off-clamp group was 150.15 +/- 60.25 mL and in the on-clamp group was 75.25+/- 40.11 mL, with a p-value of less than 0.001. There was no statistically significant difference between the two groups in terms of the most common surgical complications, postoperative drainage, overall operation time, renorrhaphy time, and postoperative bedtime.

Conclusion: The off-clamp group was shown to have a higher tumor resection duration as well as a higher rate of expected blood loss. The functional result of alterations in the estimated glomerular filtration rate seemed to be better in the off-clamp group. We expect to understand its long-term safety and oncological efficacy better as we continue to use this method.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9587890PMC
http://dx.doi.org/10.31557/APJCP.2022.23.5.1719DOI Listing

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Article Synopsis
  • - Incidences of kidney cancers are rising, and surgical resection, particularly partial nephrectomy (PN), is the preferred treatment for renal tumors, using both traditional and robot-assisted methods.
  • - A study was conducted to compare the short-term loss of estimated glomerular filtration rate (eGFR) between on-clamp and off-clamp PN, using data collected from patients diagnosed with kidney tumors between 2021 and 2024.
  • - Results showed that the off-clamp PN group experienced a 35.4% lower loss of eGFR 24 hours post-surgery compared to the on-clamp group, suggesting that off-clamp PN may provide better short-term kidney function outcomes.
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On-clamp partial nephrectomy for the surgical treatment of renal masses poses the risk of ischemia and greater post-operative renal function loss. Conversely, the off-clamp technique might enhance renal function preservation by avoiding any ischemia time. Nevertheless, the debate persists regarding the efficacy of the on- versus off-clamp partial nephrectomy in achieving better surgical, functional, and oncological outcomes.

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Introduction: In surgically excising renal masses, studies have demonstrated that tumor enucleation is an effective option. However, there is limited literature comparing off-clamp to on-clamp tumor enucleation.

Materials And Methods: We retrospectively reviewed the charts of 189 patients who underwent robotic-assisted laparoscopic partial nephrectomy via tumor enucleation by a single surgeon from March 2012 and April 2022.

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To compare perioperative outcomes of patients treated with sutureless off-clamp robotic partial nephrectomy (sl-oc RAPN) by either a novice or an expert robotic surgeon at two different institutions. Data concerning two continuous series of patients with cT1-2N0M0 renal tumors treated with sl-oc RAPN either by a novice or an expert surgeon were extracted from prospectively populated institutional databases over the last 4 years. Perioperative outcomes as well as the baseline characteristics of patients and tumors were compared by using χ and Mann-Whitney tests for categorical and continuous variables, respectively.

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Few data are available on survival outcomes of partial nephrectomy performed for cystic renal tumors. We present the first long-term oncological outcomes of cystic (cystRCC) versus pure clear cell renal cell carcinoma (ccRCC) in a propensity score-matched (PSM) analysis. Our "renal cancer" prospectively maintained database was queried for "cystRCC" or "ccRCC" and "off-clamp robotic partial nephrectomy" (off-C RPN).

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