Robotic-assisted laparoscopic partial nephrectomy. Retrospective descriptive study over a 10-year period. Anesthetic experience

  • Anabel Adell Pérez Service of Anesthesiology and Resuscitation, Hospital Universitario Donostia. San Sebastián, Spain.
  • Antia Osorio López Service of Anesthesiology and Resuscitation, Hospital Universitario Donostia. San Sebastián, Spain.
  • Borja Mugabure Bujedo Service of Anesthesiology and Resuscitation, Hospital Universitario Donostia. San Sebastián, Spain.
  • Berta Castellano Paulis Service of Anesthesiology and Resuscitation, Hospital Universitario Donostia. San Sebastián, Spain.
  • Manuel Azcona Andueza Service of Anesthesiology and Resuscitation, Hospital Universitario Donostia. San Sebastián, Spain.
  • Edurne Lodoso Ochoa Service of Anesthesiology and Resuscitation, Hospital Universitario Donostia. San Sebastián, Spain.
  • Nuria González Jorrin Service of Anesthesiology and Resuscitation, Hospital Universitario Donostia. San Sebastián, Spain.
Keywords: Nephrectomy, Laparoscopic surgery, Robot-assisted surgical procedures, Kidney neoplasms, Anesthesia

Abstract

Introduction: Robot-assisted laparoscopic surgery is currently the surgical treatment of choice for small renal masses.

Objective: Reviewing the anesthetic management and perioperative morbidity of patients undergoing robotic-assisted laparoscopic partial nephrectomy (RALPN) from 2009 to 2019 at Hospital Universitario Donostia.

Material and methods: Retrospective, descriptive, observational study involving 343 patients.

Results: 95 % of the patients were ASA II-III. Transient renal artery clamping was performed in 91 %, with a mean ischemia time of 17.79 minutes. The mean duration of the procedure under balanced general anesthesia was 184 min. Standard monitoring was performed along with invasive arterial pressure monitoring (IAP), central venous catheter (CVC) and EV1000 platform (Edwards®) for complex patients. Complications were recorded in 40 patients (11.67 %). Patients under anti-aggregation therapy experienced more bleeding than non-anti-aggregation patients (p 0.04) but did not require more transfusions. Patients with a higher anesthetic risk did not experience more complications. No statistically significant association was found between worsening renal function and the occurrence of intraoperative complications. 21 patients (6 %) were readmitted due to complications; the most frequent complication was renal artery pseudoaneurysm that required endovascular embolization.

Conclusions: It should be highlighted that after ten years of experience with this technique, the patients with a higher anesthetic risk have not experienced serious perioperative complications. RALPN is a safe technique that demands a careful anesthetic support. A robot-assisted approach alone is not a guarantee for success without strong teamwork.

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How to Cite
1.
Adell Pérez A, Osorio López A, Mugabure Bujedo B, Castellano Paulis B, Azcona Andueza M, Lodoso Ochoa E, González Jorrin N. Robotic-assisted laparoscopic partial nephrectomy. Retrospective descriptive study over a 10-year period. Anesthetic experience. Colomb. J. Anesthesiol. [Internet]. 2021Sep.9 [cited 2021Oct.16];49. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/1001

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Published
2021-09-09
How to Cite
1.
Adell Pérez A, Osorio López A, Mugabure Bujedo B, Castellano Paulis B, Azcona Andueza M, Lodoso Ochoa E, González Jorrin N. Robotic-assisted laparoscopic partial nephrectomy. Retrospective descriptive study over a 10-year period. Anesthetic experience. Colomb. J. Anesthesiol. [Internet]. 2021Sep.9 [cited 2021Oct.16];49. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/1001
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