Current Role of Pentafecta Outcomes in Open and Laparoscopic Partial Nephrectomy for Localized Renal Tumors

South Valley University70 enrolled

Overview

This study aimed to identify predictive factors associated with the achievement of pentafecta outcomes following partial nephrectomy.

Partial nephrectomy (PN) is widely considered the preferred treatment for clinical T1 (cT1) renal masses, primarily because it preserves kidney function more effectively than radical nephrectomy. The trifecta metric includes three components: warm ischemia time (WIT) of ≤ 25 minutes or cold ischemia time (CIT) of ≤ 60 minutes, negative surgical margins, and the absence of perioperative major complications. The pentafecta expands upon these criteria by adding two additional parameters: preservation of ≥ 90% of the estimated glomerular filtration rate (eGFR) and no progression in chronic kidney disease (CKD) stage within 12 months postoperatively.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Pentafecta Laparoscopic Partial Nephrectomy Renal Tumors

Interventions

Open Partial NephrectomyPROCEDURE

Patients underwent open partial nephrectomy.

Laparoscopic Partial NephrectomyPROCEDURE

Patients underwent laparoscopic partial nephrectomy.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age ≥ 18 years. * Both sexes. * Patients who diagnosed with clinical T1 or T2a N0M0 renal tumors who were suitable candidates for partial nephrectomy Exclusion Criteria: * Severe and irreversible coagulopathy. * Anatomically unfavorable tumor location. * Extensive encasement of the renal pedicle. * Diffuse invasion of the renal vein or central collecting system. * Adjacent organ invasion consistent with stage cT4 disease. * Regional lymphadenopathy (stage cTxN1), or anticipated retention of less than 20% of total nephron mass.

Locations (1)

South Valley university

South Valley, Qena Governorate, Egypt

Outcomes

Primary Outcomes

Predictor of pentafecta achievement

Predictor of pentafecta achievement, such as smoking index, was recorded.

Time frame: 12 months postoperatively

Secondary Outcomes

Amount of blood loss

Amount of blood loss was recorded.

Time frame: Intraoperatively

Surgery duration

Surgery duration was recorded.

Time frame: Intraoperatively

Length of hospital stay

Length of hospital stay was recorded from admission till the discharge from hospital.

Time frame: Till discharge from hospital (Up to one week).

Intraoperative complications

Intraoperative complications were recorded.

Time frame: Intraoperatively

Degree of pain

Each patient will be instructed about postoperative pain assessment with the visual analog scale (VAS). VAS (0 represents "no pain" while 10 represents "the worst pain imaginable").

Time frame: 24 hours postoperatively

Analgesic requirements

Incidence of required analgesic was recorded.

Time frame: 24 hours postoperatively

Incidence of complications following surgery

Incidence of complications following surgery were recorded.

Time frame: 12 months postoperatively

Data from ClinicalTrials.gov

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