Simple enucleation for the treatment of highly complex XXXX : Perioperative, functional and oncological results.

@entity1 @entity1538 @entity63 @entity5 @entity470 @entity260 @entity74 @entity703
AIM: To assess the role of @entity1538 ( @entity1538 ) for the treatment of highly complex @entity703 . METHODS: Overall, 96 Preoperative Aspects and Dimensions Used for an Anatomical (PADUA) classification score 10 to 13 @entity703 were treated with @entity1538 at our institution. All conventional perioperative variables, surgical, functional and oncological results were gathered in a prospectively maintained database. Survival curves were generated using a Kaplan-Meier method. Univariate analysis assessed the outcome differences. RESULTS: Mean (  1s.d.) clinical @entity5 diameter was 4.8 (  1.6  cm). 70.8% of @entity1 had >= cT1b stage. The PADUA score was recorded as 10, 11, 12 and 13 in 57.3%, 29.2%, 11.5%, and 2.1% of @entity5 respectively. Overall, 76 @entity1 were treated with an open approach and 20 robotically. Mean warm @entity63 time (WIT) was 19.2  min, and WIT greater than 25  min occurred in 14.6% of cases. Positive surgical margin (PSM) rate was 3.6% and trifecta was achieved in 64.3% of @entity1 . @entity260 occurred in 24% of @entity1 , with 14.6% Clavien-Dindo grade 1-2, 8.3% grade 3, and 1% grade 4. Five-year cancer specific survival (CSS), recurrent free survival (RFS), and overall survival (OS) rates resulted 96.1%, 90.8% and 88.0%, respectively. Overall, 4.2% of @entity1 experienced @entity74 . At follow-up, the mean decrease of @entity470 from preoperative value was 13.9  ml/min. This was not significantly correlated with PADUA score (p  =  0.69). The surgical approach was neither a predictor of Trifecta outcome, nor of @entity260 , WIT >25  min or PSM rate. CONCLUSIONS: @entity1538 is an effective treatment for @entity703 , with a potential key role to widen the NSS (nephron sparing surgery) indications according to guidelines.
