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Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living donor...

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Retzius-Sparing Robot-Assisted Radical Prostatectomy
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Repeat robot-assisted partial nephrectomy (RAPN): feasibility and early outcomes.

Riccardo Autorino1, Ali Khalifeh, Humberto Laydner

  • 1Center for Laparoscopic and Robotic Surgery, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH 44195, USA.

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|April 13, 2013
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Summary

Repeat robot-assisted partial nephrectomy (RAPN) is feasible and safe for kidney cancer recurrence after previous surgery. This study shows positive outcomes with no significant impact on kidney function.

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Area of Science:

  • Urology
  • Oncology
  • Minimally Invasive Surgery

Background:

  • Repeat partial nephrectomy is challenging after prior ipsilateral surgery.
  • Robot-assisted partial nephrectomy (RAPN) offers potential advantages for complex cases.
  • Assessing outcomes of repeat RAPN is crucial for managing recurrent kidney cancer.

Purpose of the Study:

  • To evaluate the feasibility of repeat robot-assisted partial nephrectomy (RAPN).
  • To report single-centre perioperative outcomes of repeat RAPN.
  • To assess safety and efficacy in patients with local recurrence post-nephron-sparing surgery (NSS).

Main Methods:

  • Retrospective review of nine patients undergoing repeat RAPN from June 2006 to June 2012.
  • Data collected included demographics, surgical history, operative details, and postoperative outcomes.
  • Analysis focused on perioperative complications, surgical margins, and renal function (eGFR).

Main Results:

  • Twelve tumours were resected in nine patients; one-third had a solitary kidney.
  • No intraoperative complications occurred; two minor postoperative complications were noted.
  • Negative surgical margins were achieved, with no significant change in estimated glomerular filtration rate (eGFR).

Conclusions:

  • Repeat RAPN is technically demanding but can be performed safely and effectively.
  • This approach is a viable option for patients with local recurrence after primary NSS.
  • Positive oncological outcomes were observed, with patients disease-free at follow-up.