• 生物技术在医药领域的应用带来了新的突破和挑战。
  • 太空探索的商业化为航天产业带来了新的投资热潮。
  • 网络安全成为数字化时代的关键挑战。
  • 网络安全问题成为全球关注的焦点,尤其是在个人数据保护方面。
  • 生物多样性的丧失引起了全球对自然保护的重视。
  • 智能家居设备的发展正在改变人们的生活方式。
  • 随着环保意识的提高,可持续消费和绿色生活方式成为新的消费趋势。
  • 随着太空探索的商业化,航天产业迎来了新的发展机遇。
  • 大数据和人工智能在商业决策中的重要性日益增加。
  • 在线教育的普及为全球学习者提供了更多样化的学习资源。
  • 虚拟现实技术在教育和娱乐领域的应用越来越广泛。
  • 可再生能源的开发利用成为全球能源政策的重要组成部分。
  • 云计算的普及正在改变企业的IT基础设施和运营模式。
  • 健康饮食和生活方式的推广正在成为社会趋势。
  • 随着全球经济不确定性增加,跨国公司的社会责任和环境影响受到更多审视。
  • 大数据和机器学习在商业决策中的作用日益凸显。
  • 在线教育的兴起为教育资源的公平分配提供了新途径。
  • 虚拟现实技术在游戏和教育领域的应用越来越广泛。
  • 海洋塑料污染问题引起了全球范围内的环保行动和政策调整。
  • 移动支付的普及正在改变消费者的支付习惯和金融行业的服务模式。
  • 随着太空探索的商业化,航天产业迎来了新的发展机遇。
  • 在线健身和健康应用的兴起反映了人们对健康生活方式的追求。
  • 环保意识的提升促使消费者更倾向于购买可持续产品。
  • 随着环保材料和可持续生产方式的推广,绿色经济正在兴起。
  • 移动支付和数字货币正在逐渐取代传统支付方式。
  • Robotic-assisted partial nephrectomy nightmare: poor clamping and tumor rupture | Paludo | Uro-Technology Journal

    Robotic-assisted partial nephrectomy nightmare: poor clamping and tumor rupture

    Artur de Oliveira Paludo, Pedro Glusman Knijnik, Dorival Manrique Duarte Jr, Elio Mazzone, Stefano Puliatti, André Kives Berger, Brasil Silva Neto, Milton Berger

    Abstract


    An 82-year-old Caucasian male patient was referred to our center because of the incidental finding of a nodule in the middle third of the right kidney during a screening abdominal ultrasound. No local or systemic symptom could be associated with the renal mass on initial evaluation. The patient underwent an abdominal contrast-enhanced CT scan, which revealed a mass in the outer middle third of the right kidney measuring 4.5 × 3.5 cm, predominantly exophytic, with contact to the collecting system and an enhancement pattern suspicious for primary renal malignancy. Tumor complexity was classified as PADUA score 9 and Renal Score 9x. Clinical stage was cT1bN0M0. Total procedure time was 130 min. Estimated blood loss was 800 mL and warm ischemia time was 24 min. Intraoperative complications were tumor rupture and increased bleeding. The postoperative course was uneventful. Meticulous preoperative planning including contrast-enhanced CT with 1 mm thick slices and 3D reconstruction imaging is critical. Comprehensive dissection of the renal hilum must be performed to access the exact number of vessels vascularizing the kidney and to provide adequate ischemia of the renal parenchyma for clean visualization during tumor resection to avoid nightmares such as positive margins and tumor rupture.

    Keywords: Partial nephrectomy, robotic surgery, complications




    Subscribe to receive issue release notifications
    and newsletters from journals