Pentafecta Achievement, Trifecta Achievement
Conditions
Keywords
Laparoscopic, Partial Nephrectomy, Trifecta, Pentafecta Achievement, Renal Tumors
Brief summary
Background: Partial nephrectomy (PN) is a reference standard for the management of the cT1 renal mass, primarily due to better preservation of renal function. The aim of this work was to determine trifecta outcomes of open PN (OPN) and laparoscopic PN (LPN) and identify predictive factors for trifecta achievement to evaluate surgical performance, including negative surgical margins, absence of severe surgical complications, and ischemia time less than 25 minutes. Objectives: this study pointing to determine trifecta outcomes of OPN and LPN and to identify predictive factors for trifecta achievement to evaluate surgical performance, including negative surgical margins, absence of severe surgical complications, and Ischemia time less than 25 Minutes.
Detailed description
Methods: This prospective, randomized study was carried out on 35 patients with clinical T1 N0M0 renal tumors. Patients were divided into two groups: Group A (n=38): underwent OPN and group B (n=32): underwent LPN.
Interventions
PROCEDUREopen partial nephrectomy
open partial nephrectomy
PROCEDURElaparoscopic partial nephrectomy
laparoscopic partial nephrectomy
Sponsors
South Valley University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* • Patients who are fit for surgery. * Patients with renal tumor who are indicated for partial nephrectomy Absolute: 1. Solitary kidney. 2. Bilateral renal tumor. 3. CDK. Relative: 1. Abnormal contralateral kidney (nephropathy, nephrolithiasis, trauma). 2. Metabolic disease associated with renal failure (DM, hypertension). 3. Genetic syndrome with tumor multifocality (VHL syndrome). Elective 1\. Clinical T1N0M0 Tumor. 2. Peripheral tumor.
Exclusion criteria
* • Patients who are unfit for surgery and who's unfit for laparoscopy. * Patients who are contraindicated for partial nephrectomy. As severe and irreversible coagulopathy. Patients who are indicated for radical nephrectomy (extensive tumor, metastatic tumor).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Predictors of Trifecta Achievement in Open ald Laparoscopic Partial Nephrectomy for Localised Renal Tumors | 2 years | Trifecta achievement is defined as the combination of (1) negative surgical margins, (2) absence of perioperative complications classified as Clavien-Dindo grade III or higher, and (3) warm ischemia time ≤25 minutes. factors affecting trifecta achievement among variables including tumor complexity score, patient comorbidities, BMI, surgical approches, special habbites, age or gender. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Pentafecta Achivement | 2 yrs | Pentafecta achievement is defined as the combination of: 1. negative surgical margins, 2. absence of major perioperative complications (Clavien-Dindo grade ≥III), 3. warm ischemia time ≤25 minutes, 4. ≥90% preservation of preoperative estimated glomerular filtration rate (eGFR), and 5. no progression to a higher CKD stage at 12 months postoperative follow-up. Data will be collected from surgical, pathological, and clinical records. Predictors of Pentafecta achievement will be analyzed using multivariable logistic regression. |
Countries
Egypt
Outcome results
None listed