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Advances in Clinical Management of Patients Undergoing Nephrectomy
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Advances in Clinical Management of Patients Undergoing Nephrectomy

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Nephrology & Urology".

Deadline for manuscript submissions: closed (20 February 2023) | Viewed by 6723

Special Issue Editor

Dr. Mihai Dorin Vartolomei

E-Mail Website
Guest Editor
Urology Department, Medical University of Vienna, Vienna, Austria
Interests: uro-oncology; cancer biology; treatment response; biomarkers and cancer
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues, 

I invite you to be part of this Special Issue of the Journal of Clinical Medicine that focuses on advances in the treatment, management, and support of patients with renal cancer undergoing nephrectomy. The present Special Issue aims to promote advances in management of patients undergoing nephrectomy.

For this Special Issue, potential topics include but are not limited to:

  • Advances in minimally invasive techniques of nephrectomy;
  • Advances in clinical management of patients undergoing nephrectomy;
  • Psychological distress related to nephrectomy;
  • Nephrectomy approach and related outcomes;
  • Advances in robotic nephrectomy;
  • Personalized treatment approach in renal cancer;
  • Machine learning and nephrectomy;
  • Artificial Intelligence and nephrectomy;
  • Biomarkers and impact on outcomes after nephrectomy;
  • Patient care and support before and after nephrectomy.

In light of these new advancements and needs, the Journal of Clinical Medicine has launched a Special Issue on “Advances in Clinical Management of Patients Undergoing Nephrectomy”. We are prioritizing high-quality original studies but also welcome well-designed meta-analyses and reviews. We look forward to your contribution.

Dr. Mihai Dorin Vartolomei
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • nephrectomy
  • clinical management
  • minimally invasive techniques
  • clinical and oncological outcomes
  • personalized treatment

Related Special Issue

Published Papers (5 papers)

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Research

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10 pages, 482 KiB  
Article
Is Continuous Wound Infiltration a Better Option for Postoperative Pain Management after Open Nephrectomy Compared to Thoracic Epidural Analgesia?
by François Crettenand, Nady Assayed-Leonardi, Felix Rohrer, Silvia Martinez Carrique and Beat Roth
J. Clin. Med. 2023, 12(8), 2974; https://doi.org/10.3390/jcm12082974 - 19 Apr 2023
Cited by 4 | Viewed by 1555
Abstract
Background: Despite increasingly advanced minimally invasive percutaneous ablation techniques, surgery remains the only evidence-based therapy in curative intent for larger (>3–4 cm) renal tumors. Although minimally invasive surgery using (robotic-assisted) laparoscopic or retroperitoneoscopic approaches has gained popularity, open nephrectomy (ON) is still performed [...] Read more.
Background: Despite increasingly advanced minimally invasive percutaneous ablation techniques, surgery remains the only evidence-based therapy in curative intent for larger (>3–4 cm) renal tumors. Although minimally invasive surgery using (robotic-assisted) laparoscopic or retroperitoneoscopic approaches has gained popularity, open nephrectomy (ON) is still performed in 25% of cases, especially in tumors with central localization (partial ON) or large tumors with/without cava thrombus (total ON). As postoperative pain is one of the drawbacks of ON, our study aims to assess recovery and post-operative pain management using continuous wound infiltration (CWI) compared to thoracic epidural analgesia (TEA). Methods: Since 2012, all patients undergoing ON at our tertiary cancer center at CHUV have been included in our prospective ERAS® (enhanced recovery after surgery) registry that is centrally stored in ERAS® Interactive Audit System (EIAS) secured server. This study represents an analysis of all patients operated on with partial or total ON at our center between 2012 and 2022. An additional analysis was performed for the estimations of the total cost of CWI and TEA, based on the diagnosis-related group method. Results: 92 patients were included and analyzed in this analysis (n = 64 (70%) with CWI; n = 28 (30%) with TEA). Adequate oral pain control was earlier achieved in the CWI group compared to the TEA group (median 3 vs. 4 days; p = 0.001), whereas immediate postoperative pain relief was better in the TEA group (p = 0.002). Consequently, opioid use was higher in the CWI group (p = 0.004). Still, reported nausea was lower in the CWI group (p = 0.002). Median time to bowel recovery was similar in both groups (p = 0.03). A shorter LOS (0.5 days) was observed in patients managed with CWI, although this was not statistically significant (p = 0.06). The use of CWI has reduced total hospital costs by nearly 40%. Conclusions: TEA has better results in terms of postoperative pain management compared to CWI following ON. However, CWI is better tolerated, and causes less nausea and earlier recovery, which leads to a shorter length of stay. Given its simplicity and cost-effectiveness, CWI should be encouraged for ON. Full article
(This article belongs to the Special Issue Advances in Clinical Management of Patients Undergoing Nephrectomy)
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Review

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7 pages, 244 KiB  
Review
Robot-Assisted Partial Nephrectomy Mid-Term Oncologic Outcomes: A Systematic Review
by Mihai Dorin Vartolomei, Mesut Remzi, Harun Fajkovic and Shahrokh F. Shariat
J. Clin. Med. 2022, 11(20), 6165; https://doi.org/10.3390/jcm11206165 - 19 Oct 2022
Cited by 7 | Viewed by 1499
Abstract
Background: Robot-assisted partial nephrectomy (RAPN) is used more and more in present days as a therapy option for surgical treatment of cT1 renal masses. Current guidelines equally recommend open (OPN), laparoscopic (LPN), or robotic partial nephrectomy (PN). The aim of this review was [...] Read more.
Background: Robot-assisted partial nephrectomy (RAPN) is used more and more in present days as a therapy option for surgical treatment of cT1 renal masses. Current guidelines equally recommend open (OPN), laparoscopic (LPN), or robotic partial nephrectomy (PN). The aim of this review was to analyze the most representative RAPN series in terms of reported oncological outcomes. (2) Methods: A systematic search of Webofscience, PUBMED, Clinicaltrials.gov was performed on 1 August 2022. Studies were considered eligible if they: included patients with renal cell carcinoma (RCC) stage T1, were prospective, used randomized clinical trials (RCT) or retrospective studies, had patients undergo RAPN with a minimum follow-up of 48 months. (3) Results: Reported positive surgical margin rates were from 0 to 10.5%. Local recurrence occurred in up to 3.6% of patients. Distant metastases were reported in up to 6.4% of patients. 5-year cancer free survival (CFS) estimates rates ranged from 86.4% to 98.4%. 5-year cancer specific survival (CSS) estimates rates ranged from 90.1% to 100%, and 5-year overall survival (OS) estimates rated ranged from 82.6% to 97.9%. (4) Conclusions: Data coming from retrospective and prospective series shows very good oncologic outcomes after RAPN. Up to now, 10-year survival outcomes were not reported. Taken together, RAPN deliver similar oncologic performance to OPN and LPN. Full article
(This article belongs to the Special Issue Advances in Clinical Management of Patients Undergoing Nephrectomy)
8 pages, 237 KiB  
Review
Quality of Life and Psychological Distress among Patients with Small Renal Masses
by Liliana Vartolomei, Andrei Cotruș, Camelia Stanciu, Cristian Delcea, Marco Tozzi, Elena Lievore, Felice Crocetto, Francesco Del Giudice, Giuseppe Lucarelli, Matteo Muto and Matteo Ferro
J. Clin. Med. 2022, 11(14), 3944; https://doi.org/10.3390/jcm11143944 - 7 Jul 2022
Cited by 16 | Viewed by 2056
Abstract
Background: Quality of life (QoL) and psychological distress represent an important aspect of the daily life of cancer patients. The aim of this systematic review was to critically analyze available literature regarding QoL and psychological distress in patients with small renal masses (SRMs). [...] Read more.
Background: Quality of life (QoL) and psychological distress represent an important aspect of the daily life of cancer patients. The aim of this systematic review was to critically analyze available literature regarding QoL and psychological distress in patients with small renal masses (SRMs). (2) Methods: A systematic search of EMBASE, PUBMED and American Psychological Association (APA-net) was performed on 30 April 2022. Studies were considered eligible if they included patients with SRMs, had a prospective or retrospective design, included at least 10 patients, were published in the last 20 years, and assessed the QoL or psychological distress in patients that underwent active surveillance (AS) in comparison to those that underwent ablation/surgery treatments. (3) Results: The patients that underwent AS were statistically significantly older, with smaller renal masses than those that underwent surgery/ablation. A study showed a significant reduction in total scores of Short Form-12 (SF-12) among AS patients when compared to partial nephrectomy (PN) patients at enrollment (95.0 ± 15.8 vs. 99.1 ± 13.9), 2 years (91.0 ± 16.4 vs. 100.3 ± 14.3), and at 3 years (92.9 ± 15.9 vs. 100.3 ± 14.3), p < 0.05, respectively. That was mainly due to lower physical health scores. On the other hand, another study showed that AS patients with a biopsy-proven malignant tumor had a worse psychological distress sub-score (PDSS) compared to patients treated with surgery/ablation after biopsy. (4) Conclusions: It seems that there is an influence on QoL and psychological distress while on AS of SMRs. However, due to the low amount of available data, the impact of AS or active treatment on QoL or psychological distress of patients with small renal masses warrants further investigation. Full article
(This article belongs to the Special Issue Advances in Clinical Management of Patients Undergoing Nephrectomy)

Other

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3 pages, 211 KiB  
Reply
Reply to Beilstein, C.M.; Wuethrich, P.Y. Comment on “Crettenand et al. Is Continuous Wound Infiltration a Better Option for Postoperative Pain Management after Open Nephrectomy Compared to Thoracic Epidural Analgesia? J. Clin. Med. 2023, 12, 2974”
by François Crettenand, Nady Assayed-Leonardi, Felix Rohrer, Silvia Martinez Carrique and Beat Roth
J. Clin. Med. 2023, 12(18), 5918; https://doi.org/10.3390/jcm12185918 - 12 Sep 2023
Viewed by 469
Abstract
We appreciate your comprehensive comment [...] Full article
(This article belongs to the Special Issue Advances in Clinical Management of Patients Undergoing Nephrectomy)
3 pages, 203 KiB  
Comment
Comment on Crettenand et al. Is Continuous Wound Infiltration a Better Option for Postoperative Pain Management after Open Nephrectomy Compared to Thoracic Epidural Analgesia? J. Clin. Med. 2023, 12, 2974
by Christian Marco Beilstein and Patrick Yves Wuethrich
J. Clin. Med. 2023, 12(18), 5917; https://doi.org/10.3390/jcm12185917 - 12 Sep 2023
Cited by 1 | Viewed by 437
Abstract
We have read with great interest the retrospective study recently published by Crettenand et al. in this journal [...] Full article
(This article belongs to the Special Issue Advances in Clinical Management of Patients Undergoing Nephrectomy)
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