Early unclamping reduces partial nephrectomy complications

  • J Urol
  • 26 Jun 2019

  • International Clinical Digest
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Takeaway

  • Early unclamping (EU) during robotic partial nephrectomy can reduce postoperative complications such as renal pseudoaneurysm and urine leak.

Why this matters

  • Although experienced robotic surgeons may be familiar with the EU technique, few studies have thoroughly investigated it.

Study design

  • Researchers reviewed the health records of patients who underwent robotic partial nephrectomy with EU for presumed renal malignancy (N=463; men, 62.6%; BMI >30 kg/m2, 43.8%; mean tumor size, 3.1 cm) and compared outcomes with other partial nephrectomy studies. 
  • Funding: None disclosed.

Key results

  • The postoperative complication rate within 30 days was 14.7%; 88% of complications were Clavien-Dindo grades I-II.
  • 1 patient (0.2%) experienced urine leak after simultaneous partial nephrectomy and pyelolithotomy for partial staghorn stone.
  • No patients had postoperative renal pseudoaneurysm.

Limitations

  • The study was retrospective and single center, with no randomization.