Location:Room London (Hall B2, level 0)
Management of renal masses less than 7 cm is a matter of debate. Patient and renal masses characteristics open a variaty of possible treatments. The objectives of the session are to review how to better characterise these tumours with a critical review of the role of biopsies. Afterwards a debate will be established trying to define when to go for active surveillance in the not-so-small (T1b) tumours as well as the role of the different types of focal therapy. Finally, it will explore the limits of nephron-sparing surgery.
The aim of this presentation is to review the role of biopsy and surveillance for cT1b renal masses.
Aim of this presentation will be to review the current role of kidney ablation for the management of small renal masses. A critical analysis of the available evidence will be provided, including comparative outcomes with other treatment options.
Institutes: 1IRCCS Ospedale San Raffaele, Dept. of Urology, Milan, Italy, 2Western General Hospital, Dept. of Urology, Edinburgh, United Kingdom, 3Vienna Medical University, Dept. of Urology, Vienna, Austria, 4Maggiore Della Carità Hospital, Dept. of Urology, Novara, Italy, 5Hacettepe University, Dept. of Urology, Ankara, Turkey, 6Papa Giovanni XXIII Hospital, Dept. of Urology, Bergamo, Italy, 7Radboud University Medical Center, Dept. of Urology, Nijmegen, The Netherlands, 8Donauspital, Dept. of Urology, Vienna, Austria, 9Fundacio-Puigvert, Dept. of Urology, Barcelona, Spain, 10Kent & Canterbury Hospital, Dept. of Urology, Canterbury, United Kingdom, 11Azienda Ospedaliera Universitaria Careggi, Dept. of Urology, Florence, Italy, 12Lmu Grosshadern, Dept. of Urology, Munich, Germany
Institutes: 1Irccs Ospedale San Raffaele; Uri, Dept. of Urology, Milan, Italy, 2OLV Vattikuti Robotic Surgery Institute, Dept. of Urology, Melle, Belgium, 3Ohio Health Dublin Methodist Hospital, Dept. of Urology, Dublin, United States of America, 4Hertfordshire and South Bedfordshire Urological Cancer Centre, Lister Hospital, Dept. of Urology, Stevenage, United Kingdom, 5Medanta Kidney and Urology Institute, Dept. of Urology and Renal Transplantation, Medanta, India, 6Humanitas Clinical and Research Center, Dept. of Urology, Rozzano Milan, Italy, 7MRC Centre For Transplantation, King’s College London, Dept. of Urology, London, United Kingdom, 8Peter MacCallum Cancer Centre, Dept. of Urology, Melbourne, Australia, 9University of Miami Miller School of Medicine and Sylvestor Comprehensive Cancer Center, Dept. of Urology, Miami, United States of America, 10San Luigi Gonzaga Hospital, University of Turin, Dept. of Urology, Orbassano, Italy, 11Rajiv Gandhi Cancer Hospital, Dept. of Urology, New Delhi, India, 12Vattikuti Urology Institute, Henry Ford Hospital, Dept. of Urology, Detroit, United States of America
Previous studies assessed predictors of kidney failure after partial nephrectomy. However, evidence is scarce regarding the impact of preoperative patient characteristics on the risk of renal failure after robot-assisted partial nephrectomy (RAPN) in patients with renal cell carcinoma (RCC) and normal preoperative renal function. The aim of our multi-institutional study was to assess preoperative predictors of renal failure after RAPN in patients with normal renal function.
Institutes: 1CHU Rennes, Dept. of Urology, Rennes, France, 2Pitié-Salpétrière Hospital, Dept. of Urology, Paris, France, 3CHU Bordeaux, Dept. of Urology, Bordeaux, France, 4CHU Toulouse, Dept. of Urology, Toulouse, France, 5CHU Angers, Dept. of Urology, Angers, France, 6CHU Rouen, Dept. of Urology, Rouen, France, 7Georges Pompidou Hospital, Dept. of Urology, Paris, France, 8Kremlin-Bicetre Hospital, Dept. of Urology, Paris, France
The aim was to compare perioperative and oncological outcomes of RPN and OPN.
The charts of all patients who underwent OPN or RPN from 2006 to 2014 at six academic departments of urology were retrospectively reviewed.
In this study, RPN was less morbid than OPN with lower complications, decreased blood loss and shorter length of stay. Intermediate-term oncologic outcomes were similar in both groups.
Institutes: UKS Universitätsklinikum des Saarlandes, Dept. of Urology, Homburg, Germany
Nephron sparing surgery (NSS) offers comparable oncological control with improved long-term prevention form cardio-vascular disease compared to radical nephrectomy. However, since the introduction of minimal invasive surgery, radical nephrectomy rates increased. The aim of our study was to analyse the outcome of patients with complex renal tumours (PADUA score ≥10) who underwent robot-assisted partial nephrectomy (RAPN). The results show that RAPN of highly complex renal tumours is feasible in experienced hands with acceptable major complication rates. Therefore even highly complex renal tumours may not limit the indication for using RAPN.
Institutes: University Hospital of Bordeaux, Dept. of Urology and Kidney Transplant, Bordeaux, France
This video present a case of laparoscopic partial nephrectomy for multiple tumors done with the Da Vinci surgical robot. It aims to illustrate the benefit of superselective clamping technique in minimizing renal ischaemia during the surgery of a 28 year-old patient suffering from the Von Hippel Lindau disease with 6 lesions on the left kidney, including one larger than 4cm.