title: Renal transposition during minimally invasive partial nephrectomy: a safe technique for excision of upper pole tumors.
abstract: Minimally invasive partial nephrectomy (MIPN) for upper pole masses, particularly for those located posteriorly, is challenging because of difficult visualization during tumor resection and renorrhaphy. Complete renal transposition facilitates access to and excision of upper pole renal masses during MIPN. Sixteen patients with upper pole renal masses underwent laparoscopic or robot-assisted partial nephrectomy with renal transposition from October 2009 to March 2012 with a mean follow-up of 22 months. Mean operative time was 242.6 minutes, and mean warm ischemic time was 14.7 minutes. No patient needed an intraoperative or postoperative blood transfusion. Five (31%) patients had a postoperative complication (four Clavien grade I, one Clavien grade II). There were no delayed complications, positive surgical margins, or tumor recurrences. Mean postoperative eGFR change within 3 months was -9.4%. These results show that complete renal transposition can be safely used to facilitate excision of upper pole tumors.
authors.affiliation: Department of Surgery, Division of Urology, Beth Israel Deaconess Medical Center, Boston, Massachusetts 02215, USA.
authors.forename: Joshua R
authors.initials: JR
authors.lastname: Kaplan
authors.forename: Peter
authors.initials: P
authors.lastname: Chang
authors.forename: Andrew G
authors.initials: AG
authors.lastname: Percy
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Wagner
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods*; D011446:Prospective Studies; D012371:Robotics; D025321:Surgery, Computer-Assisted / Q000009:adverse effects; D016896:Treatment Outcome; D052096:Warm Ischemia