Retroperitoneoscopic kidney resection with preoperative selective embolization and fluorescent visualization of renal vessels. Analysis of postoperative Complications

Authors

  • U. V. Dumanskiy Institute of Experimental Pathology, Oncology and Radiobiology, NAS of Ukraine, Kyiv, Dnipro Regional Oncological Centre, Dnipro
  • O. I. Balashova Institute of Experimental Pathology, Oncology and Radiobiology, NAS of Ukraine, Kyiv, Dnipro Regional Oncological Centre, Dnipro
  • S. O. Reshetniak Institute of Experimental Pathology, Oncology and Radiobiology, NAS of Ukraine, Kyiv, Dnipro Regional Oncological Centre, Dnipro
  • R. E. Kavetsky Institute of Experimental Pathology, Oncology and Radiobiology, NAS of Ukraine, Kyiv, Dnipro Regional Oncological Centre, Dnipro

DOI:

https://doi.org/10.11603/2414-4533.2020.3.11214

Keywords:

localized kidney cancer, retroperitoneoscopic kidney resection, indocyanine green, superselective X-ray vascular emboliza-tion of the kidney

Abstract

The aim of the work: to analyze postoperative complications in patients with local kidney cancer after retroperitoneoscopic resection of the kidney with preoperative selective embolization and fluorescent imaging of renal vessels.

Materials and Methods. We operated on 25 patients with local kidney cancer and performed an analysis of registered postoperative complications.

Results and Discussion. All patients with local renal cell carcinoma of the kidney underwent resection of the kidney (ZERO ishemia) using intraoperative fluorescent imaging in the infrared region of the spectrum using Indocyanine green. At the preoperative stage, all patients underwent superselective X-ray vascular embolization. Complications were analyzed using the generally accepted Clavien-Dindo postoperative complications scale.

No complications were reported during surgery. One complication was registered at the preoperative stage, and only 3 complications (12 %) were registered in the postoperative stage. All complications were of degrees 1–2, and did not require re-surgical correction and did not affect the length of stay in the intensive care unit and surgical hospital, did not require additional manipulations and procedures such as blood transfusions, endoscopic and interventional radiological interventions.

The analysis of the registered postoperative complications after retroperitoneoscopic resection using preoperative X-ray vascular embolization and intraoperative fluorescent imaging in the infrared region of the spectrum with indoctanine and postoperative complications, recommend the benefits of this surgical technique.

These data suggest that the use of superselective X-ray vascular embolization and intraoperative fluorescent imaging in the surgical treatment of localized kidney cancer has significant advantages over the "standard" method of surgical treatment. The authors of this publication see the prospects for further study and implementation of the proposed algorithm for examination and treatment of patients with local kidney cancer.

References

Chow, W.-H., Dong, L.M., & Devesa, S.S. (2010). Epidemiology and risk factors for kidney cancer. Nat. Rev. Urol.,7 (5), 245-257. DOI: https://doi.org/10.1038/nrurol.2010.46

Scelo, G., Hofmann, J.N., Banks, R.E., Bigot, P., Bhatt, R.S., Cancel-Tassin, G., …, & Vasudev, N.S. (2016). International cancer seminars: a focus on kidney cancer. Ann. Oncol., 27 (8), 1382-1385. DOI: https://doi.org/10.1093/annonc/mdw186

Fedorenko, Z.G., Gulak, L.O., Mihailovich, U.I. Horokh, Ye.L., Ryzhov, A.Yu., Sumkina, O.V., & Kutsenko, L.B. (2019). Rak v Ukraini, 2017-2018. Zakhvoriuvanist, smertnist, pokaznyky diialnosti onkolohichnoi sluzhby [Cancer in Ukraine, 2017-2018. Morbidity, mortality, indicators of oncological service activity]. Byul. Nats. kantser-reiestru Ukrainy – Bull. Nat. Cancer Registry of Ukraine, 20. Kyiv: Nats. instytut raku [in Ukrainian].

Fedorenko, Z.G., Gulak, L.O., Mihailovich, U.I. Horokh, Ye.L., Ryzhov, A.Yu., Sumkina, O.V., & Kutsenko, L.B. (2019). Rak v Ukraini, 2013-2014. Zakhvoriuvanist, smertnist, pokaznyky diialnosti onkolohichnoi sluzhby [Cancer in Ukraine, 2017-2018. Morbidity, mortality, indicators of oncological service activity]. Byul. Nats. kantser-reyestru Ukrainy – Bull. Nat. Cancer Registry of Ukraine, 16. Kyiv: Nats. instytut raku [in Ukrainian].

Diaz de Leon, A. & Pedrosa, I. (2017). Imaging and screening of kidney cancer. Radiol. Clin. North Am., 55 (6), 1235-1250. DOI: https://doi.org/10.1016/j.rcl.2017.06.007

Kay, F.U., & Pedrosa, I. (2018). Imaging of solid renal masses. Urol. Clin. North Am., 45 (3), 311-330. DOI: https://doi.org/10.1016/j.ucl.2018.03.013

Gray, R.E., & Harris, G.T. (2019). Renal cell carcinoma: Diagnosis and management. Am. Fam. Physician, 99 (3), 179184.

Rossi, S.H., Prezzi, D., Kelly-Morland, C., & Goh, V. (2018). Imaging for the diagnosis and response assessment of renal tumours. World J. Urol., 36 (12), 1927-1942. DOI: https://doi.org/10.1007/s00345-018-2342-3

Ouyang, A.-M., Wei, Z.-L., Su, X.-Y., Li, K., Zhao, D., Yu, D.-X., & Ma. X.-X. (2017). Relative computed tomography (CT) enhancement value for the assessment of microvascular architecture in renal cell carcinoma. Med. Sci. Monit., 23, 3706-3714. DOI: https://doi.org/10.12659/MSM.902957

Cheng, S.-H., Liu, J.-M., Liu, Q.-Y., Luo, D.-Y., Liao, B.-H., Li, H., & Wang K.-J. (2014). Prognostic role of microvessel density in patients with renal cell carcinoma: A meta-analysis. Int. J. Clin. Exp. Pathol., 7 (9), 5855-5863.

Canter, D., Kutikov, A., Manley, B., Egleston, B., Simhan, J., Smaldone, M., ..., & Uzzo, R.G. Utility of the R.E.N.A.L.-Nephrometry scoring system in objectifying treatment decision. Urology, 78 (5), 1089-1094. DOI: https://doi.org/10.1016/j.urology.2011.04.035

Brookman-May, S. (2016). Utility of nephrometric score sin kidney cancer surgery. European Urology Supplements, 15, 2, 37, 37a. DOI: https://doi.org/10.1016/S1569-9056(16)30011-2

Simmons, M.N., Ching, C.B., Samplaski, M.K., Park, C.H., & Gill, I.S. (2010). Kidney tumor location measurement using the c index method. J. Urol., 183 (5), 1708-1713. DOI: https://doi.org/10.1016/j.juro.2010.01.005

Alyaev, U.G., Sirota, E.S., Rapoport, L.M., Bezrukov, E.A., Suhanov, R.B., & Tsarichenko, D.G. (2018). Sravnenie znachimosti shkal nephrometricheskoi otsenki RENAL, PADUA, С-INDEX dlya prognoza slozhnosti laparoskopicheskoi rezektsii pochki [Comparison of significance of scales of nefrometric assessment renal, padua, c-index for forecasting complexity of laparoscopic kidney resection]. Oncourologiya – Oncourology, 14, 1, 36–46 [in Russian].

Shatilko, T.V., Popkov, V.M., Koroliov, A.U., & Chausovskiy, D.A. (2017). Sravnenie nephrometricheskih system pri partsialnoi nephrektomii po povodu pochechnokletochnogo raka [Comparison of nephrometric systems in partial nephrectomy in patients with renal cell carcinoma]. Rosiiskiy medico-biologicheckiy vestnik ym. akad. Y. P. Pavlova – Russian Medical and Biological Bulletin after named acad. I.P. Pavlova, 25, 1, 2500–2546 [in Russian].

González, J., Cózar, J.M., Gómez, A., Fernández-Pérez, C., & Esteban, M. (2015). Nephron-sparing surgery in renal cell carcinoma: Current perspectives on technical issues. Curr. Urol. Rep., 16 (2), 6. DOI: https://doi.org/10.1007/s11934-014-0475-5

Ljungberg, B. (2004). Nephron-sparing surgery-strategies for partial nephrectomy in renal cell carcinoma. Scand. J. Surg., 93 (2), 126-131. DOI: https://doi.org/10.1177/145749690409300207

Greco, F., Autorino, R., Altieri, V., Campbell, S., Ficarra, V., Gill, I. ..., & van Poppel, H. (2019). Ischemia techniques in nephron-sparing surgery: A systematic review and meta-analysis of surgical, oncological, and functional outcomes. Eur. Urol., 75 (3), 477-491.

Funahashi, Y., Yoshino, Y., Sassa, N., Matsukawa, Y., Takai, S., & Gotoh, M. (2014). Comparison of warm and cold ischemia on renal function after partial nephrectomy. Urology, 84 (6), 1408-1412.

Campbell, S., Uzzo, R.G., Allaf, M.E., Bass, E.B., Cadeddu, J.A., & Chang, A. (2017). Renal mass and localized renal cancer: AUA guideline. J. Urol., 198 (3), 520-529. DOI: https://doi.org/10.1016/j.juro.2017.04.100

Peña, J.A., Oliveira, M., Ochoa, D.C., Santillana, J.M., Skrobot, S.A., Castellarnau, S., ..., & Villavicencio, H. (2013). The road to real zero ischemia for partial nephrectomy. J. Endourol., 27 (7), 936-942. DOI: https://doi.org/10.1089/end.2012.0676

Shekarriz, B., Upadhyay, J., Shekarriz, H., de Assis Mendes Goes Jr, F., Bianco, F.J., Tiguert, R., ..., & Wood Jr, D.P. (2002). Comparison of costs and complications of radical and partial nephrectomy for treatment of localized renal cell carcinoma. Urology, 59 (2), 211-215. DOI: https://doi.org/10.1016/S0090-4295(01)01514-X

Tan, W.S., Berg, S., Cole, A.P., Krimphove, M., Marchese, M., Lipsitz, S.R., Nabi, …, & Trinh, Q.-D. (2019). Comparing long-term outcomes following radical and partial nephrectomy for cT1 renal cell carcinoma in young and healthy. JNCI Cancer Spectr, 3 (1), pkz003. DOI: https://doi.org/10.1093/jncics/pkz003

Ebbing, J., Menzel, F., Frumento, P., Miller, K., Ralla, B., Fuller, T.F., …, & Kempkensteffen, C. (2019). Outcome of kidney function after ischaemic and zero-ischaemic laparoscopic and open nephron-sparing surgery for renal cell cancer. BMC Nephrol., 20, 40.

Qi, J., Yu, Y., Huang, T., Bai, Q., Kang, J., Liang, J., & Wu, Y. (2013). Predictors of postoperative renal functional damage after nephron-sparing surgery. World J. Surg. Oncol., 11, 216. DOI: https://doi.org/10.1186/1477-7819-11-216

Greco, F., Autorino, R., Altieri, V., Campbell, S., Ficarra, V., Gill, I., …, & van Poppel, H. (2019). Techniques in Nephron-sparing surgery: A systematic review and meta-analysis of surgical, oncological, and functional outcomes. Eur. Urol., 75 (3), 477-491. DOI: https://doi.org/10.1016/j.eururo.2018.10.005

Funahashi, Y., Yoshino, Y., Sassa, N., Matsukawa, Y., Takai, S., & Gotoh, M. (2014).

Comparison of warm and cold ischemia on renal function after partial nephrectomy. Urology, 84 (6), 1408-1412. DOI: https://doi.org/10.1016/j.urology.2014.08.040

Petros, F.G., Keskin, S.K., Yu, K.-J., Li, R., Metcalfe, M.J., Fellman, B.M., …, & Wood, C.G. (2018). Intraoperative conversion from partial to radical nephrectomy: Incidence, predictive factors, and outcomes. Urology, 116, 114-119. DOI: https://doi.org/10.1016/j.urology.2018.03.017

Mir, M.C., Derweesh, I., Porpiglia, F., Zargar, H., Mottrie, A., & Autorino, R. (2017).

Partial nephrectomy versus radical nephrectomy for clinical T1b and T2 renal tumors: A systematic review and meta-analysis of comparative studies. Eur. Urol., 71 (4), 606-617. DOI: https://doi.org/10.1016/j.eururo.2016.08.060

Volpe, A., Blute, M.L., Ficarra, V., Gill, I.S., Kutikov, A., Porpiglia, F., ..., & Thompson, R.H. (2015). Renal ischemia and function after partial nephrectomy: A collaborative review of the literature. European Urology, 68 (1), 61-74. DOI: https://doi.org/10.1016/j.eururo.2015.01.025

Ebbing, J., Menzel, F., Frumento, P., Miller, K., Ralla, B., Fuller, T.F., …, & Kempkensteffen, C. (2019). Outcome of kidney function after ischaemic and zero-ischaemic laparoscopic and open nephron-sparing surgery for renal cell cancer. BMC Nephrol, 20, 40.

Jia, Z., Li, X.S., Zhang, C.J., Yang, K.W., Peng, D., Yang, J.H., …, & Zhou, L.Q. (2017). The impact to operation safety of preoperative renal artery embolization for management of diameter≥10 cm renal cell carcinoma. Zhonghua wai ke za zhi [Chinese journal of surgery], 55 (10), 738-741.

Provenza, G., Sparagna, A., Cunsolo, G.V., Tierno, S.M., Centanini, F., Bellotti, C., & Mezzetti, G. (2013). Renal artery embolization in a gross kidney neoplasm. G. Chir., 34 (9-10), 263-266.

Haochen, W., Jian, W., Li, S., Tianshi, L., Xiaoqiang, T., & Yinghua, Z. (2019).

Superselective renal artery embolization for bleeding complications after percutaneous renal biopsy: a single-center experience. J. Int. Med. Res., 47 (4), 1649-1659. DOI: https://doi.org/10.1177/0300060519828528

Bakal, C.W., Cynamon, J., Lakritz, P.S., & Sprayregen, S. (1993). Near-infrared fluorescence imaging to facilitate super-selective arterial clamping during zero-ischemia robotic partial nephrectomy. J. Vasc. Interv. Radiol., 4, 6, 727-731. DOI: https://doi.org/10.1016/S1051-0443(93)71958-2

Borofsky, M.S., Gill, I.S., Hemal, A.K., Marien, T.P., Jayaratna, I., Krane, L.S., & Stifelman, M.D. (2017). Near-infrared fluorescence imaging to facilitate super-selective arterial clamping during zero-ischemia robotic partial nephrectomy. BJU Int., 111, 604-610. DOI: https://doi.org/10.1111/j.1464-410X.2012.11490.x

Xia, L., Wang, X., Xu, T., & Guzzo, T.J. (2017). Systematic review and meta-analysis of comparative studies reporting perioperative outcomes of robot-assisted partial nephrectomy versus open partial nephrectomy. J. Endourol., 31 (9), 893-909. DOI: https://doi.org/10.1089/end.2016.0351

Kunath, F., Schmidt, S., Krabbe, L.‐M., Miernik, A., Dahm, P., Cleves, A., Walther, M., & Kroeger, N. (2017). Partial nephrectomy versus radical nephrectomy for clinical localised renal masses. Cochrane Database of Syst. Rev., 2017, 5, Art. No.: CD012045.

MacLennan, S., Imamura, M., Lapitan, M.C., Omar, M.I., Lam, T.B.L., Hilvano-Cabungcal, A.M., …, & N'Dow, J. (2012). Systematic review of oncological outcomes following surgical management of localised renal cancer. Eur. Urol., 61 (5), 972-993. DOI: https://doi.org/10.1016/j.eururo.2012.02.039

Deng, W., Li, J., Liu, X., Chen, L., Liu, W., Zhou, X., ..., & Wang, G. (2020).

Robot‐assisted versus laparoscopic partial nephrectomy for anatomically complex T1b renal tumors with a RENAL nephrometry score ≥7: A propensity score‐based analysis. Cancer Med., 9 (2), 586-594. DOI: https://doi.org/10.1002/cam4.2749

Klatte, T., Ficarra, V., Gratzke, C., Kaouk, J., Kutikov, A., Macchi, V., …, & Porpiglia, F. (2015). A literature review of renal surgical anatomy and surgical strategies for partial nephrectomy. Eur. Urol., 68 (6), 980-992. DOI: https://doi.org/10.1016/j.eururo.2015.04.010

Azhar, R.A., Metcalfe, C., Gill, I.S., & Azhar R.A. (2015). Anatomic partial nephrectomy: Technique evolution. Curr. Opin. Urol., 25 (2), 95-99. DOI: https://doi.org/10.1097/MOU.0000000000000140

Fan, X., Xu, K., Lin, T., Liu, H., Yin, Z., Dong, W., Huang, H., & Huang, J. (2013).

Comparison of transperitoneal and retroperitoneal laparoscopic nephrectomy for renal cell carcinoma: a systematic review and meta-analysis. BJU Int., 111, 4, 611-621. DOI: https://doi.org/10.1111/j.1464-410X.2012.11598.x

Ng, C.S., Gill, I.S., Ramani, A.P., Steinberg, A.P., Spaliviero, M., Abreu, S.C., ..., & Desai, M.M. (2005). Transperitoneal versus retroperitoneal laparoscopic partial nephrectomy: Patient selection and perioperative outcomes. J. Urol., 174 (3), 846-849. DOI: https://doi.org/10.1097/01.ju.0000169259.49754.02

Mitropoulos, D., Artibani, W., Biyani, C.S., Jensen, J.B., Rouprêt, M., & Truss, M. (2018). Validation of the Clavien-Dindo grading system in urology by the European association of urology guidelines Ad Hoc Panel. Eur. Urol. Focus, 4 (4), 608-613. DOI: https://doi.org/10.1016/j.euf.2017.02.014

Published

2020-10-23

How to Cite

Dumanskiy, U. V., Balashova, O. I., Reshetniak, S. O., & Kavetsky, R. E. (2020). Retroperitoneoscopic kidney resection with preoperative selective embolization and fluorescent visualization of renal vessels. Analysis of postoperative Complications. Hospital Surgery. Journal Named by L.Ya. Kovalchuk, (3), 55–62. https://doi.org/10.11603/2414-4533.2020.3.11214

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EXPERIENCE OF WORK