Is Open Partial Nephrectomy Still an Option for Challenging Renal Masses?

Michael A. Brooks, MD, presented “Is Open Partial Nephrectomy Still an Option for Challenging Renal Masses?” during the 25th Innovations in Urologic Practice conference on September 26, 2021, in Santa Fe, New Mexico.

How to cite: Brooks, Michael A. “Is Open Partial Nephrectomy Still an Option for Challenging Renal Masses?” September 26th, 2021. Accessed Nov 2024. https://grandroundsinurology.com/is-open-partial-nephrectomy-still-an-option-for-challenging-renal-masses/

Is Open Partial Nephrectomy Still an Option for Challenging Renal Masses?

Michael A. Brooks, MD, Assistant Professor of Urology and Oncology at Baylor College of Medicine in Houston, Texas, evaluates open partial nephrectomy as an option for challenging renal masses and compares it to the robotic retroneoscopic and laparoscopic techniques. He begins by discussing three patient cases, each one using a different treatment option. The robotic retroneoscopic partial nephrectomy patient experienced minimal blood loss, an operation time of 4 hours, and was discharged on the 3rd day post-op. The laparoscopic partial nephrectomy patient also had minimal blood loss, a 3-hour operation time, and was discharged on post-op day 3. The open partial nephrectomy patient experienced greater blood loss, a 5-hour operation time, and was discharged on post-op day 2. Dr. Brooks also explained the technique for each, highlighting the importance of port placement for robotic surgery, a lack of cortical stitches to avoid compressing the kidney for open partial nephrectomy, and the use of intraoperative ultrasound for all three procedures. He then considers two papers, the first of which found that oncological outcomes for open and robotic patients were very similar but that open partial nephrectomy produced higher blood loss, longer ischemia time, and a longer post-op course in patients. The second paper focused on the impact of specific surgeons and found that surgeon skillset and experience created high variability in outcomes. Dr. Brooks concludes that open partial nephrectomy remains a good option for complex renal masses, that the approach can vary from patient to patient based on tumor characteristics, and that the approach is likely less important than surgeon training, experience, and case volume.

About The 25th Annual Innovations in Urologic Practice:

Presented by co-chairs Mohit Khera, MD, MBA, MPH, and Michael Coburn, MD, FACS, the Innovations in Urologic Practice conference provides a detailed review and commentary on multiple genitourinary and urologic diseases. Among the featured oncological topics are bladder cancer and immunotherapies, as well as upper tract cancer management, prostate cancer, including state-of-the-art imaging, focal therapy, and MRI. Experts also discuss new tools and techniques for nephrectomy and treating advanced renal cell carcinoma. In terms of general urological approaches, the conference also includes pelvic reconstruction and trauma, men’s health topics like male infertility and sexual dysfunction, and ways to diagnose and treat infections in the urology patient. Dr. Brooks presented this talk at the 2021 conference.

For further educational activities from this conference, visit our collection page.