Skip to main content
Springer Nature Link
Log in

Renorrhaphy techniques and effect on renal function with robotic partial nephrectomy

  • Topic Paper
  • Published:
World Journal of Urology Aims and scope Submit manuscript

A Letter to the Editor to this article was published on 13 June 2020

Abstract

Purpose

The role of robotic partial nephrectomy (RPN) is becoming increasingly prevalent in managing small renal masses. Renal functional outcomes have been reported with relation to the amount of healthy renal parenchyma resected and ischemia time; however, there is limited data on the effect of renorrhaphy on long-term renal function. Our aim is to evaluate the impact of renorrhaphy technique on renal functional outcomes.

Methods

A nonsystematic literature review was performed to retrieve articles assessing renorrhaphy techniques and renal function outcomes, specifically focusing on single-layer vs. traditional two-layer renorrhaphy.

Results

Performing single-layer renorrhaphy while omitting cortical renorrhaphy appears to improve renal function postoperatively, based on very limited studies in the literature that were evaluated.

Conclusion

Single-layer renorrhaphy may be associated with improved postoperative renal function and could prove to be useful in patients with chronic renal insufficiency or solitary kidney. The ongoing clinical trial NCT02131376 may provide further information on the impact of renorrhaphy technique on long-term renal function.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Explore related subjects

Discover the latest articles and news from researchers in related subjects, suggested using machine learning.

References

  1. Campbell S, Uzzo RG, Allaf ME, Bass EB, Cadeddu JA, Chang A, Clark PE, Davis BJ, Derweesh IH, Giambarresi L, Gervais DA, Hu SL, Lane BR, Leibovich BC, Pierorazio PM (2017) Renal mass and localized renal cancer: AUA guideline. J Urol 198(3):520–529. https://doi.org/10.1016/j.juro.2017.04.100

    Article  PubMed  Google Scholar 

  2. Bahler CD, Cary KC, Garg S, DeRoo EM, Tabib CH, Kansal JK, Monn MF, Flack CK, Masterson TA, Sandrasegaran MK, Foster RS, Sundaram CP (2015) Differentiating reconstructive techniques in partial nephrectomy: a propensity score analysis. Can J Urol 22(3):7788–7796

    PubMed  Google Scholar 

  3. Kardos SV, Gross CP, Shah ND, Schulam PG, Trinh QD, Smaldone MC, Sun M, Weight CJ, Sammon J, Han LC, Kim SP (2014) Association of type of renal surgery and access to robotic technology for kidney cancer: results from a population-based cohort. BJU Int 114(4):549–554. https://doi.org/10.1111/bju.12711

    Article  PubMed  Google Scholar 

  4. Patel HD, Mullins JK, Pierorazio PM, Jayram G, Cohen JE, Matlaga BR, Allaf ME (2013) Trends in renal surgery: robotic technology is associated with increased use of partial nephrectomy. J Urol 189(4):1229–1235. https://doi.org/10.1016/j.juro.2012.10.024

    Article  PubMed  Google Scholar 

  5. Buffi NM, Saita A, Lughezzani G, Porter J, Dell'Oglio P, Amparore D, Fiori C, Denaeyer G, Porpiglia F, Mottrie A (2019) Robot-assisted partial nephrectomy for complex (PADUA Score %3e/=10) tumors: techniques and results from a multicenter experience at four high-volume centers. LID. doi:10.1016/j.eururo.2019.03.006

  6. Hung AJ, Cai J, Simmons MN, Gill IS (2013) "Trifecta" in partial nephrectomy. J Urol 189(1):36–42. https://doi.org/10.1016/j.juro.2012.09.042

    Article  PubMed  Google Scholar 

  7. Bahler CD, Sundaram CP (2016) Effect of renal reconstruction on renal function after partial nephrectomy. J Endourol 30(Suppl 1):S37–41. https://doi.org/10.1089/end.2016.0055

    Article  PubMed  Google Scholar 

  8. Groshar D, Moskovitz B, Kastin A, Issaq E, Nativ O (1999) Renal function after tumor enucleation: assessment by quantitative SPECT of 99mTc-dimercaptosuccinic acid uptake by the kidneys. J Nucl Med 40(6):968–971

    CAS  PubMed  Google Scholar 

  9. Lane BR, Russo P, Uzzo RG, Hernandez AV, Boorjian SA, Thompson RH, Fergany AF, Love TE, Campbell SC (2011) Comparison of cold and warm ischemia during partial nephrectomy in 660 solitary kidneys reveals predominant role of nonmodifiable factors in determining ultimate renal function. J Urol 185(2):421–427. https://doi.org/10.1016/j.juro.2010.09.131

    Article  PubMed  Google Scholar 

  10. Mir MC, Campbell RA, Sharma N, Remer EM, Simmons MN, Li J, Demirjian S, Kaouk J, Campbell SC (2013) Parenchymal volume preservation and ischemia during partial nephrectomy: functional and volumetric analysis. Urology 82(2):263–268. https://doi.org/10.1016/j.urology.2013.03.068

    Article  PubMed  Google Scholar 

  11. Gettman MT, Blute ML, Chow GK, Neururer R, Bartsch G, Peschel R (2004) Robotic-assisted laparoscopic partial nephrectomy: technique and initial clinical experience with DaVinci robotic system. Urology 64(5):914–918. https://doi.org/10.1016/j.urology.2004.06.049

    Article  PubMed  Google Scholar 

  12. Jeon HG, Gong IH, Hwang JH, Choi DK, Lee SR, Park DS (2012) Prognostic significance of preoperative kidney volume for predicting renal function in renal cell carcinoma patients receiving a radical or partial nephrectomy. BJU Int 109(10):1468–1473. https://doi.org/10.1111/j.1464-410X.2011.10531.x

    Article  PubMed  Google Scholar 

  13. Sharma N, O'Hara J, Novick AC, Lieber M, Remer EM, Herts BR (2008) Correlation between loss of renal function and loss of renal volume after partial nephrectomy for tumor in a solitary kidney. J Urol 179(4):1284–1288. https://doi.org/10.1016/j.juro.2007.11.071

    Article  PubMed  Google Scholar 

  14. Simmons MN, Fergany AF, Campbell SC (2011) Effect of parenchymal volume preservation on kidney function after partial nephrectomy. J Urol 186(2):405–410. https://doi.org/10.1016/j.juro.2011.03.154

    Article  PubMed  Google Scholar 

  15. Gill IS, Eisenberg MS, Aron M, Berger A, Ukimura O, Patil MB, Campese V, Thangathurai D, Desai MM (2011) "Zero ischemia" partial nephrectomy: novel laparoscopic and robotic technique. Eur Urol 59(1):128–134. https://doi.org/10.1016/j.eururo.2010.10.002

    Article  PubMed  Google Scholar 

  16. Bertolo R, Campi R, Klatte T, Kriegmair MC, Mir MC, Ouzaid I, Salagierski M, Bhayani S, Gill I, Kaouk J, Capitanio U (2018) Suture techniques during laparoscopic and robot-assisted partial nephrectomy: a systematic review and quantitative synthesis of peri-operative outcomes. BJU Int. https://doi.org/10.1111/bju.14537

    Article  PubMed  Google Scholar 

  17. Antonelli A, Veccia A, Francavilla S, Bertolo R, Bove P, Hampton LJ, Mari A, Palumbo C, Simeone C, Minervini A, Autorino R (2019) On-clamp versus off-clamp robotic partial nephrectomy: a systematic review and meta-analysis. Urologia 86(2):52–62. https://doi.org/10.1177/0391560319847847

    Article  PubMed  Google Scholar 

  18. Minervini A, Campi R, Sessa F, Derweesh I, Kaouk JH, Mari A, Rha KH, Sessa M, Volpe A, Carini M, Uzzo RG (2017) Positive surgical margins and local recurrence after simple enucleation and standard partial nephrectomy for malignant renal tumors: systematic review of the literature and meta-analysis of prevalence. Miner Urol Nefrol 69(6):523–538. https://doi.org/10.23736/s0393-2249.17.02864-8

    Article  Google Scholar 

  19. Veccia A, Antonelli A, Hampton LJ, Greco F, Perdona S, Lima E, Hemal AK, Derweesh I, Porpiglia F, Autorino R (2019) Near-infrared fluorescence imaging with indocyanine green in robot-assisted partial nephrectomy: pooled analysis of comparative studies. Eur Urol Focus. https://doi.org/10.1016/j.euf.2019.03.005

    Article  PubMed  Google Scholar 

  20. Xu C, Lin C, Xu Z, Feng S, Zheng Y (2019) Tumor enucleation vs. partial nephrectomy for T1 Renal cell carcinoma: a systematic review and meta-analysis. Front Oncol 9:473. doi:10.3389/fonc.2019.00473.

  21. Bahler CD, Dube HT, Flynn KJ, Garg S, Monn MF, Gutwein LG, Mellon MJ, Foster RS, Cheng L, Sandrasegaran MK, Sundaram CP (2015) Feasibility of omitting cortical renorrhaphy during robot-assisted partial nephrectomy: a matched analysis. J Endourol 29(5):548–555. https://doi.org/10.1089/end.2014.0763

    Article  PubMed  Google Scholar 

  22. Lu Q, Zhao X, Ji C, Guo S, Liu G, Zhang S, Li X, Gan W, Guo H (2017) Modified laparoscopic simple enucleation with single-layer suture technique versus standard laparoscopic partial nephrectomy for treating localized renal cell carcinoma. Int Urol Nephrol 49(2):239–245. https://doi.org/10.1007/s11255-016-1470-1

    Article  PubMed  Google Scholar 

  23. Williams RD, Snowden C, Frank R, Thiel DD (2017) Has sliding-clip renorrhaphy eliminated the need for collecting system repair during robot-assisted partial nephrectomy? J Endourol 31(3):289–294. https://doi.org/10.1089/end.2016.0562

    Article  PubMed  Google Scholar 

  24. Bertolo R, Campi R, Mir MC, Klatte T, Kriegmair MC, Salagierski M, Ouzaid I, Capitanio U (2019) Systematic review and pooled analysis of the impact of renorrhaphy techniques on renal functional outcome after partial nephrectomy. Eur Urol Oncol 2(5):572–575. https://doi.org/10.1016/j.euo.2018.11.008

    Article  PubMed  Google Scholar 

  25. Swavely NR, Anele UA, Porpiglia F, Mir MC, Hampton LJ, Autorino R (2019) Optimization of renal function preservation during robotic partial nephrectomy. Therap Adv Urol 11:1756287218815819. https://doi.org/10.1177/1756287218815819

    Article  Google Scholar 

  26. Goh YS, Wu MW, Tai BC, Lee KC, Raman L, Teo BW, Vathsala A, Tiong HY (2013) Comparison of creatinine based and kidney volume based methods of estimating glomerular filtration rates in potential living kidney donors. J Urol 190(5):1820–1826. https://doi.org/10.1016/j.juro.2013.05.117

    Article  CAS  PubMed  Google Scholar 

  27. Porpiglia F, Bertolo RG, Amparore D, Angusti T, Di Dio M, Piramide F, Fiori C (2016) Single-layer versus double-layer renorrhaphy during minimally-invasive partial nephrectomy: are there effects on renal function? Eur Urol Suppl 15(7):236. https://doi.org/10.1016/S1569-9056(16)15193-0

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Urology, Indiana University School of Medicine, 535 Barnhill Drive, Suite 420, Indianapolis, IN, 46202, USA

    Kashyap Shatagopam, Clinton D. Bahler & Chandru P. Sundaram

Authors
  1. Kashyap Shatagopam
    View author publications

    You can also search for this author inPubMed Google Scholar

  2. Clinton D. Bahler
    View author publications

    You can also search for this author inPubMed Google Scholar

  3. Chandru P. Sundaram
    View author publications

    You can also search for this author inPubMed Google Scholar

Contributions

KS: data collection, manuscript writing. CDB: data collection, manuscript editing. CPS: project development, manuscript editing.

Corresponding author

Correspondence to Chandru P. Sundaram.

Ethics declarations

Conflict of interest

No competing financial interests exist.

Research involving human participants and/or animals

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Shatagopam, K., Bahler, C.D. & Sundaram, C.P. Renorrhaphy techniques and effect on renal function with robotic partial nephrectomy. World J Urol 38, 1109–1112 (2020). https://doi.org/10.1007/s00345-019-03033-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00345-019-03033-w

Keywords