During partial nephrectomy surgery, efforts at minimizing ischemia while maximizing renal parenchymal volume are desirable to preserve renal function1,2. Not only clamping of the hilum but the renorrhaphy portion of the procedure also can have a significant negative impact on renal function3-5. It is possible to perform this procedure without clamping the hilum and also without formal renorrhaphy. However robust prospective formal evaluation of safety, risks, and potential benefits and whether or not the technique can be employed in a generalized fashion has not been studied. Demonstration of safety and generalizability may open a whole new avenue of approaching nephron sparing and renal function sparing kidney surgery and decrease potential risks for long term kidney disease in patients with renal masses. This study will investigate the safety, efficacy, and generalizability of the use of clampless, sutureless partial nephrectomy in the treatment of renal cell carcinoma.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
59
All subjects will undergo a clampless, sutureless robotic partial nephrectomy.
University of Florida
Gainesville, Florida, United States
Positive margin rate
Determine the positive margin rate, as measured on the pathology report 2-3 weeks post-surgery.
Time frame: 2-3 weeks post-surgery
Transfusion rate
Determine the transfusion rate, as measured approximately 4 weeks post-surgery via review of patient medical records.
Time frame: 4 weeks post-surgery
Renal dysfunction (1 day post-surgery)
Determine subject renal dysfunction, measured using estimated glomerular filtration rate using Cockcroft-gault formula, at 1-day post-surgery.
Time frame: 1 day post-surgery
Renal dysfunction (2-3 weeks post-surgery)
Determine subject renal dysfunction, measured using estimated glomerular filtration rate using Cockcroft-gault formula, at 2-3 weeks post-surgery.
Time frame: 2-3 weeks post-surgery
Renal dysfunction (6 months post-surgery)
Determine subject renal dysfunction, measured using estimated glomerular filtration rate using Cockcroft-gault formula, at 6 months post-surgery.
Time frame: 6 months post-surgery
Estimated blood loss
Determine the estimated blood loss, as determined on the operative report.
Time frame: at time of partial nephrectomy
Need for ischemia
Determine how many subjects have a need for ischemia, as determined by need to clamp or not.
Time frame: at time of partial nephrectomy
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