2019 Volume 47 Issue 3 Pages 95-103
Purpose: We evaluated the surgical outcomes of non-renorrhaphy, mini-incision partial nephrectomy using a soft-coagulation system.
Methods: Non-renorrhaphy mini-incision, partial nephrectomy was performed in 33 consecutive patients with small renal tumors between April 2016 and March 2019. After tumor resection, the soft-coagulation system was used to achieve hemostasis. A TachoSilⓇ or BOLHEALⓇ was used on the resection bed. The urinary collecting system was only sutured if it was opened. The surgical outcomes of each patient were retrospectively evaluated.
Results: The patients’ mean age was 66.8 (36–83) years. The mean tumor size, operative time, and amount of intraoperative blood loss were 25.7 mm, 230 (140–357) min, and 292.2 (0–1332) mL, respectively. In 8 patients, the renal artery was clamped during the operation (mean warm ischemia time: 7.4 [2–18] min). The urinary collecting system was sutured in 18 patients. Two complications of Clavien-Dindo grade III or worse occurred: postoperative bleeding, which required a blood transfusion, and complete atrioventricular block (A-V block), which required temporary cardiac pacing. The A-V block spontaneously resolved a few days after the operation, and cardiac pacing was not required thereafter. The surgical margins were negative in all cases, and no tumor recurrence was observed during the observational period (681.8 [16–1126] days). The mean (range) rate of change in the estimated glomerular filtration rate at one year after surgery was −9.0% (−21.8–14.3%).
Conclusion: Non-renorrhaphy partial nephrectomy using a soft-coagulation system is safe and produces acceptable oncological outcomes.
