Nephron Sparing Surgery Using a Bipolar Radio Frequency Resection Device

Wesley White, Frederick A. Klein, W Waters

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Purpose: We evaluated operative outcomes during nephron sparing surgery using a handheld radio frequency ablation resection device. Materials and Methods: Patients with a newly diagnosed renal mass who elected treatment were prospectively enrolled in a comparative trial designed to evaluate the usefulness of the handheld HABIB 4X™ radio frequency ablation device during open nephron sparing surgery. Preoperative variables were determined and patients subsequently underwent open nephron sparing surgery with (group 1) or without (control group 2) the assistance of the radio frequency ablation device. Data were collected on preoperative and postoperative creatinine and hematocrit, estimated operative blood loss, intraoperative and postoperative complications, and pathological outcomes. Results: A total of 90 patients underwent open nephron sparing surgery with (45) and without (45) the radio frequency ablation device. Mean pathological tumor size was 3.31 and 3.13 cm in groups 1 and 2, respectively (p = 0.49). Mean estimated blood loss was 133.2 and 417.2 cc in groups 1 and 2, respectively (p <0.001). Mean operative time was 83.5 and 97.2 minutes in groups 1 and 2, respectively (p = 0.012). Ten of 45 group 2 patients underwent hilar clamping with hypothermia, while no patients in group 1 underwent hilar clamping. Margins were positive in 1 patient in group 1 (2.2%) and in 2 in group 2 (4.4%). Group 1 complications included postoperative urine leakage in 1 case, which required stent placement. Group 2 complications included 2 cases of urine leakage requiring stent placement, 4 of blood transfusion, 2 of ureteral lacerations, 2 episodes of clot retention and 1 death. Conclusions: The handheld radio frequency ablation device can yield a significant benefit during open nephron sparing surgery, namely decreased blood loss and operative time.

Original languageEnglish (US)
Pages (from-to)2343-2347
Number of pages5
JournalJournal of Urology
Volume180
Issue number6
DOIs
StatePublished - Dec 1 2008
Externally publishedYes

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Nephrons
Radio
Equipment and Supplies
Operative Time
Constriction
Stents
Urine
Lacerations
Intraoperative Complications
Hypothermia
Hematocrit
Blood Transfusion
Creatinine
Kidney
Control Groups
Neoplasms

All Science Journal Classification (ASJC) codes

  • Urology

Cite this

Nephron Sparing Surgery Using a Bipolar Radio Frequency Resection Device. / White, Wesley; Klein, Frederick A.; Waters, W.

In: Journal of Urology, Vol. 180, No. 6, 01.12.2008, p. 2343-2347.

Research output: Contribution to journalArticle

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abstract = "Purpose: We evaluated operative outcomes during nephron sparing surgery using a handheld radio frequency ablation resection device. Materials and Methods: Patients with a newly diagnosed renal mass who elected treatment were prospectively enrolled in a comparative trial designed to evaluate the usefulness of the handheld HABIB 4X™ radio frequency ablation device during open nephron sparing surgery. Preoperative variables were determined and patients subsequently underwent open nephron sparing surgery with (group 1) or without (control group 2) the assistance of the radio frequency ablation device. Data were collected on preoperative and postoperative creatinine and hematocrit, estimated operative blood loss, intraoperative and postoperative complications, and pathological outcomes. Results: A total of 90 patients underwent open nephron sparing surgery with (45) and without (45) the radio frequency ablation device. Mean pathological tumor size was 3.31 and 3.13 cm in groups 1 and 2, respectively (p = 0.49). Mean estimated blood loss was 133.2 and 417.2 cc in groups 1 and 2, respectively (p <0.001). Mean operative time was 83.5 and 97.2 minutes in groups 1 and 2, respectively (p = 0.012). Ten of 45 group 2 patients underwent hilar clamping with hypothermia, while no patients in group 1 underwent hilar clamping. Margins were positive in 1 patient in group 1 (2.2{\%}) and in 2 in group 2 (4.4{\%}). Group 1 complications included postoperative urine leakage in 1 case, which required stent placement. Group 2 complications included 2 cases of urine leakage requiring stent placement, 4 of blood transfusion, 2 of ureteral lacerations, 2 episodes of clot retention and 1 death. Conclusions: The handheld radio frequency ablation device can yield a significant benefit during open nephron sparing surgery, namely decreased blood loss and operative time.",
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