One Of The Most Ignored Method For The Gemcitabine

The question is the value of robots for experienced Succimer laparoscopic urologic surgeons: is the quality of a robotic partial nephrectomy (RPN) better than that of an LPN performed by an experienced laparoscopist? Five comparative studies with more than 100 cases have been reported in the literature, including two matched comparisons (Table?2) [52-56], but there have been no RCT. The operation time for RPN was shorter than that for LPN in two studies and longer in one study [52, 53, 56]. The estimated blood loss was less for RPN in one study but greater in another study [52, 54]. The WIT of RPN was shorter than that of LPN in two studies and longer in one study [52, 53, 55]. The complication rates and positive surgical margin (PSM) rates were similar for RPN and LPN. Ellison et?al. compared RPN performed by five surgeons with minimal experience in RPN and LPN performed by one experienced laparoscopic surgeon; the results indicated a learning curve only for RPN [55]. The longer WIT for RPN in this study could be because of the surgeons�� minimal experience in RPN. In a meta-analysis of 717 partial nephrectomies from seven studies comparing RPN and LPN outcomes, Aboumarzouk et?al. found no differences between the two groups regarding operative times, estimated blood loss, or conversion rates [57]. However, RPN had significantly less WIT than LPN (P?=?0.0008) [57]. The conclusion of these comparisons is that RPN is feasible and comparable to LPN performed by experienced laparoscopic surgeons, with a slightly shorter WIT. RPN is particularly useful for challenging tumors with www.selleckchem.com/products/Gemcitabine-Hydrochloride(Gemzar).html a large diameter and/or difficult location near the renal hilum. To assess the complexity of a renal mass, several scoring system such as the radius, endophytic, nearness to collecting system, anterior/posterior, and location (RENAL) nephrometry score [58], Preoperative Aspects and Dimensions Used for an Anatomical classification [59], and the centrality index have been described [60]. In partial nephrectomies for complex tumors with a RENAL nephrometry score greater than 7, Long et?al. demonstrated that RPN had a lower rate of conversion to radical nephrectomy (1% vs 11.5%, P?selleck shorter operative time (196.9 vs 240.7?min, P?