title: "Off-clamp, non-renorrhaphy" laparoscopic partial nephrectomy with perirenal fat and Gerota's fascia reapproximation: initial experience and perioperative outcomes.
abstract: OBJECTIVE
  To describe our initial experience of "off-clamp, non-renorrhaphy" laparoscopic partial nephrectomy (OCNR-LPN) with perirenal fat and Gerota's fascia reapproximation technique.
  
  
  METHODS
  Between August 2012 and March 2013, 24 consecutive patients underwent OCNR-LPN at our institution. After the renal mass excision, biologic hemostatics such as FLOSEAL™ and TISSEEL™ (both from Baxter Healthcare Corp., Deerfield, IL) were used, and the perirenal fat and Gerota's fascia were sutured for reapproximation.
  
  
  RESULTS
  All 24 consecutive patients underwent OCNR-LPN successfully. The warm ischemic time for all cases was 0 minute. Thirteen patients were noted to have a low (4-6) RENAL nephrometry score (RNS), and 11 patients had a moderate (7-9) RNS. The mean tumor size among this cohort was 2.9 (range, 1.2-6.0) cm, and the mean estimated blood loss was 243 (range, 50-700) mL. The mean hospital stay was 6.9 (range, 5-10) days. The mean percentage of postoperative estimated glomerular filtration rate change increased by 0.9%. No positive surgical margins were noted, and 2 patients with Grade III complication by the Clavien-Dindo classification were treated by endoscopic or radiological intervention.
  
  
  CONCLUSIONS
  OCNR-LPN with the perirenal fat and Gerota's fascia reapproximation technique is feasible. Our initial experience with OCNR-LPN demonstrates encouraging results of minimal renal function loss and complications.
authors.affiliation: Department of Urology, Kosin University Gospel Hospital , Busan, Korea.
authors.forename: Taek Sang
authors.initials: TS
authors.lastname: Kim
authors.forename: Jeong Hyun
authors.initials: JH
authors.lastname: Oh
authors.forename: Hyun Yul
authors.initials: HY
authors.lastname: Rhew
mesh_terms: D000038:Abscess / Q000188:drug therapy / Q000209:etiology; D000328:Adult; D000368:Aged; D057868:Anastomotic Leak / Q000209:etiology / Q000628:therapy; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004322:Drainage; D000071938:Fasciotomy; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D016896:Treatment Outcome; D052096:Warm Ischemia
chemical_list: D000900:Anti-Bacterial Agents