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One challenge of robot-assisted partial nephrectomy (RAPN) is to reduce operative blood loss. Partial nephrectomy (PN) is a complex surgery that is being made easier by robotic assistance. In this study, we determined whether the use of hemostatic clips during the tumor resection step reduced blood loss during robot-assisted partial nephrectomy. Methods: In this retrospective study, we included all consecutive patients who underwent RAPN in our university hospital from 2017 to 2019. Three experienced surgeons performed the surgery. One surgeon used Hemo-lock hemostatic clips during tumor resection to prevent bleeding, and two did not. Blood loss in the two groups was compared as the primary endpoint. The duration of clamping, operative time, complications, surgical margins, transfusions, serum creatinine and hemoglobin were compared as secondary endpoints. Results: 53 patients were included, 36 in the No-clip group and 17 in the Clip group. Our two groups were comparable for age, weight, Charlson score, tumor size and RENAL score. There was a significant difference between the two groups for median blood loss 50 mL in the Clip group versus 300 mL in the No-clip group (p = 0.0001), whereas median operating time was shorter in the No-clip group, 140 min versus 180 min for the Clip group (p = 0.044). No other criterion showed a significant difference. The use of Hemo-lock during the tumor resection step in RAPN reduced blood loss without impairing renal function. Larger studies are still needed to confirm our findings.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Clip Group | Use of Hemo-lock hemostatic clips during tumor resection to prevent bleeding |
| |
| No Clip group | No Hemo-lock hemostatic clips used during tumor resection |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Patial nephrectomy | Procedure | Partial nephrectomy assisted with robot to remove kidney cancer |
|
| Measure | Description | Time Frame |
|---|---|---|
| Blood loss in the two groups was compared | It was mesured during the surgery by amount of blood drawn | 3 years |
| Measure | Description | Time Frame |
|---|---|---|
| operative time | duration from the begining to the end of the surgery | 3 years |
| duration of clamping | time between the clips set and remove during the surgery for patient of clip group |
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Inclusion Criteria:
Exclusion Criteria:
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all consecutive patients who underwent Robot Assisted Partial Nephrectomy
no data sharing plan has been established
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| ID | Term |
|---|---|
| D007680 | Kidney Neoplasms |
| D006470 | Hemorrhage |
| ID | Term |
|---|---|
| D014571 | Urologic Neoplasms |
| D014565 | Urogenital Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
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Renal tumor
| 3 years |
| incidence of complications | rate of complication after surgery | 3 years |
| D052776 |
| Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D007674 | Kidney Diseases |
| D014570 | Urologic Diseases |
| D052801 | Male Urogenital Diseases |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |