Patients with renal cancer are commonly treated by robot-assisted partial nephrectomy. Renal artery clamping is commonly required inducing kidney ischemia during surgery. It impacts parenchymal and renal function. This study aims to compare a new surgical procedure in order to reduce ischemia effect and preserve renal function after partial nephrectomy for renal tumour.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
31
The device used to performe the surgery is a Da Vinci robot. After injection of infracyanine, the super-selective clamping is possible. The surgery is performed using a specific clamping of the tumor arteries. Super-selective ischemia is checked using near infrared fluorescence.
Partial nephrectomy is performed with the conventional method in wich a renal artery clamping is done.
University Hospital Grenoble-Alps (CHU-GA)
La Tronche, France
Benefit on postoperative renal function of fluorescence-enhanced super-selective clamping during robot assisted partial nephrectomy compared with robot-assisted partial nephrectomy with renal artery clamping
The glomerular filtration rate (GFR) of the kidney operated is assessed at 6 months after surgery. This value is compared to that assessed before the surgery to see the variation. This variation is compare between the two groups.
Time frame: 6 months
Number of group conversion in the zero ischemia method.
The feasibility of the new technique is assessed by counting the number of group conversion towards conventional technique.
Time frame: 6 months
Surgical duration in the two groups
Duration between the first incision and the skin closure
Time frame: 6 months
Complications
number of complications per and post-surgery up to 1 month
Time frame: 1 month
Per-surgery blood loss
per-surgery blood loss in millimeter
Time frame: 1 month
Hemoglobine rate variation
For patients having no received blood transfusion, the hemoglobine rate variation is assessed in percentage at one month in post-surgery.
Time frame: 1 month
Positive surgical margins
Number of positive surgical margins
Time frame: 1 month
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Variation between global GFR in the two groups
The variation of the global GFR is assessed after surgery, when patient is discharged. This value is compared to the that collected before the surgery.
Time frame: 6 months
Renal parenchyma preserved
The percentage of renal parenchyma preserved is evaluated by CT renal volumetry at 6 months after the surgery. The value is compared to that collected before the surgery.
Time frame: 6 months