Access the full text.
Sign up today, get DeepDyve free for 14 days.
K. Beasley, Mohamed Omar, A. Shaikh, D. Bochinski, A. Khakhar, J. Izawa, Randy Welch, J. Chin, A. Kapoor, P. Luke (2004)
Laparoscopic versus open partial nephrectomy.Urology, 64 3
James Brown, S. Hubosky, L. Gomella, S. Strup (2004)
Hand assisted laparoscopic partial nephrectomy for peripheral and central lesions: a review of 30 consecutive cases.The Journal of urology, 171 4
W. Morgan, H. Zincke (1990)
Progression and survival after renal-conserving surgery for renal cell carcinoma: experience in 104 patients and extended followup.The Journal of urology, 144 4
M. Timsit, J. Bazin, N. Thiounn, E. Fontaine, Y. Chrétien, B. Dufour, A. Méjean (2006)
Prospective study of safety margins in partial nephrectomy: intraoperative assessment and contribution of frozen section analysis.Urology, 67 5
D. Kubinski, P. Clark, D. Assimos, M. Hall (2004)
Utility of frozen section analysis of resection margins during partial nephrectomy.Urology, 64 1
(2004)
MC: Utility of frozen section analysis of resection margins during partial nephrectomy. Urology 2004;64:31–34
H. Zincke, H. Ruckle (1995)
Use of exogenous material to bolster closure of the parenchymal defect following partial nephrectomy.Urology, 46 1
A. Lapini, S. Serni, A. Minervini, L. Masieri, M. Carini (2005)
Progression and long-term survival after simple enucleation for the elective treatment of renal cell carcinoma: experience in 107 patients.The Journal of urology, 174 1
J. Thrasher, J. Robertson, D. Paulson (1994)
Expanding indications for conservative renal surgery in renal cell carcinoma.Urology, 43 2
A. Nadu, N. Kitrey, Y. Mor, J. Golomb, J. Ramon (2005)
Laparoscopic partial nephrectomy: is it advantageous and safe to clamp the renal artery?Urology, 66 2
E. Ray, B. Turney, Rajinder Singh, A. Chandra, D. Cranston, TIMOTHY O’BRIEN (2006)
Open partial nephrectomy: outcomes from two UK centresBJU International, 97
K. Weld, R. Venkatesh, Jessica Huang, J. Landman (2006)
Evolution of surgical technique and patient outcomes for laparoscopic partial nephrectomy.Urology, 67 3
(2005)
Winfield HN: Technique for ensuring negative surgical margins during laparoscopic partial nephrectomy
Thai Nguyen, Justin Parkinson, David Kuehn, H. Winfield (2005)
Technique for ensuring negative surgical margins during laparoscopic partial nephrectomy.Journal of endourology, 19 3
Quan-lin Li, H. Guan, Qiu-ping Zhang, Li-zhi Zhang, Fa-peng Wang, Yong-ji Liu (2003)
Optimal margin in nephron-sparing surgery for renal cell carcinoma 4 cm or less.European urology, 44 4
M. Carini, A. Minervini, A. Lapini, L. Masieri, S. Serni (2006)
Simple enucleation for the treatment of renal cell carcinoma between 4 and 7 cm in greatest dimension: progression and long-term survival.The Journal of urology, 175 6
M. Eroğlu, A. Ünsal, H. Bakırtaş, Ümi˙t Tekdoğan, Ö. Ataoǧlu, M. Balbay (2005)
Routine frozen-section biopsy from the surgical bed should be performed during nephron-sparing surgery for renal cell carcinomaScandinavian Journal of Urology and Nephrology, 39
(2006)
outcomes for laparoscopic partial nephrectomy. Urology 2006;67:502–506
C. Diblasio, M. Snyder, P. Russo (2006)
Mini‐flank supra‐11th rib incision for open partial or radical nephrectomyBJU International, 97
A. Moinzadeh, I. Gill, A. Finelli, J. Kaouk, M. Desai (2006)
Laparoscopic partial nephrectomy: 3-year followup.The Journal of urology, 175 2
David Miller, J. Hollingsworth, K. Hafez, S. Daignault, B. Hollenbeck (2006)
Partial nephrectomy for small renal masses: an emerging quality of care concern?The Journal of urology, 175 3 Pt 1
P. Russo (2006)
Prospective study of safety margins in partial nephrectomy: Intraoperative assessment and contribution of frozen section analysisUrologic Oncology-seminars and Original Investigations, 24
B. Leibovich, M. Blute, J. Cheville, C. Lohse, A. Weaver, H. Zincke (2004)
Nephron sparing surgery for appropriately selected renal cell carcinoma between 4 and 7 cm results in outcome similar to radical nephrectomy.The Journal of urology, 171 3
M. Duvdevani, M. Laufer, A. Kastin, Y. Mor, A. Nadu, J. Hanani, O. Nativ, J. Ramon (2005)
Is frozen section analysis in nephron sparing surgery necessary? A clinicopathological study of 301 cases.The Journal of urology, 173 2
Background/Aims: Partial nephrectomy (PN) is more challenging in solitary kidneys and when tumors are interpolar, hilar, endophytic, deeply penetrating, large or irregular. We propose an alternative ‘two-step’ technique for assuring negative margins and consistent parenchymal preservation in these situations. Methods: We retrospectively reviewed 6 open and 3 hand-assisted laparoscopic PNs performed between November 2001 and August 2005. Tumor enucleation was followed by resection of an approximate 1 cm thick rim (wafer) of tissue from the tumor bed. Clinical variables and intraoperative data were reviewed. Results: Mean patient age was 57.4 years (49–69 years). Mean enucleated tumor diameter was 3.7 cm (1–9 cm). Three of nine (33%) enucleated tumors had positive margins. The wafer surface adjacent to the enucleated specimen was positive in all three, and the average depth of tumor invasion into the wafer was 5.4 mm (3.2–8 mm). The wafer surface adjacent to normal parenchyma was never positive. The average wafer depth removed was 1.19 cm. Average vessel clamp and total operative times were 24.5 and 295 minutes, respectively. Mean estimated blood loss was 372 ml. Mean preoperative and postoperative creatinine was 1.05 and 1.53 mg/dl, respectively. No patient has developed a local or distant recurrence (mean follow-up 27.1 months). Conclusions: A ‘two-step’ PN appears to be an effective surgical margin and renal parenchymal preserving technique. It is important to remove a 1 cm thick wafer as 1/3 of cases demonstrated tumor infiltration to a depth of 3–8 mm. This technique minimizes the need to address a positive frozen section margin.
Current Urology – Karger
Published: Jan 1, 2010
Keywords: Enucleation; Nephron sparing surgery; Partial nephrectomy; Renal cell carcinoma
Read and print from thousands of top scholarly journals.
Already have an account? Log in
Bookmark this article. You can see your Bookmarks on your DeepDyve Library.
To save an article, log in first, or sign up for a DeepDyve account if you don’t already have one.
Copy and paste the desired citation format or use the link below to download a file formatted for EndNote
Access the full text.
Sign up today, get DeepDyve free for 14 days.
All DeepDyve websites use cookies to improve your online experience. They were placed on your computer when you launched this website. You can change your cookie settings through your browser.