Evidence map›Paper›PMID 35006078›Full record

ArticleJMIR formative research2022

Short-Term and Long-Term Renal Outcomes in Patients With Obesity After Minimally Invasive Versus Open Partial Nephrectomy for the Treatment of Renal Cancer: Retrospective Study.

Brittany Flippo, Bradley Stone, Shelbie Stahr, Mahmoud Khalil, Rodney Davis, Mohamed Kamel, Manisha Singh

Abstract read
In one paragraph

Article in JMIR formative research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Brittany Flippo *University of Arkansas for Medical Sciences, Little Rock, AR, United States.ORCID https://orcid.org/0000-0002-3241-9127
Bradley Stone *University of Arkansas for Medical Sciences, Little Rock, AR, United States.ORCID https://orcid.org/0000-0002-0877-6853
Shelbie StahrUniversity of Arkansas for Medical Sciences, Little Rock, AR, United States.ORCID https://orcid.org/0000-0002-3761-4036
Mahmoud KhalilUniversity of Arkansas for Medical Sciences, Little Rock, AR, United States.ORCID https://orcid.org/0000-0001-9007-2945
Rodney DavisUniversity of Arkansas for Medical Sciences, Little Rock, AR, United States.ORCID https://orcid.org/0000-0003-0751-5704
Mohamed KamelUniversity of Arkansas for Medical Sciences, Little Rock, AR, United States.ORCID https://orcid.org/0000-0002-3353-3554
Manisha Singh *University of Arkansas for Medical Sciences, Little Rock, AR, United States.ORCID https://orcid.org/0000-0002-6014-1337

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundObesity is significantly associated with renal cell carcinoma. Surgery is the preferred treatment for demarcated lesions of renal cell carcinoma; however, obesity increases the complexity of surgical outcomes. Minimally invasive surgical techniques are preferred over open partial nephrectomy (OPN), but controversy remains regarding the most efficacious technique in patients with obesity.

objectiveThis study aims to determine whether minimally invasive partial nephrectomy (MIPN) or OPN better preserves renal function and investigate short- and long-term renal outcomes in patients with obesity undergoing a partial nephrectomy.

methodsWe conducted a retrospective chart review of 242 adult patients aged ≥18 years who underwent MIPN or OPN between January 1, 2005, and December 31, 2016, at the University of Arkansas for Medical Sciences. Using creatinine as a measure of kidney function, patients' preoperative levels were compared with their postoperative levels in 2-time frames: short (3-6 months postsurgery) or long (>6 months). The primary outcome was the change in creatinine values from preoperative to >6 months postoperatively in patients with obesity. Secondary outcomes included the change in creatinine values from preoperative to 3 to 6 months postoperatively in patients with obesity who underwent MIPN versus OPN. We also analyzed the creatinine values of nonobese patients (BMI <30) who underwent partial nephrectomy using the same time frames. Unconditional logistic regression was used to estimate crude and multivariable-adjusted odds ratios (ORs) and 95% CI to observe associations between surgery type and changes in creatinine values from while stratifying for obesity.

resultsA total of 140 patients were included in the study, of whom 75 were obese and 65 were nonobese. At >6 months after MIPN (n=20), the odds of patients with obesity having a decrease or no change in creatinine values was 1.24 times higher than those who had OPN (n=13; OR 1.24, 95% CI 0.299-6.729; P=.80). At 3 to 6 months after MIPN (n=27), the odds were 0.62 times lower than those after OPN (n=17; OR 0.62, 95% CI 0.140-2.753; P=.56). In the nonobese group, at 3 to 6 months after undergoing minimally invasive surgery (n=18), the odds of having a decrease or no change in creatinine values was 4.86 times higher than those who had open surgery (n=21; OR 4.86, 95% CI 1.085-21.809; P=.04). At more than 6 months after MIPN (n=14), the odds were 4.13 times higher than those after OPN (n=11; OR 4.13, 95% CI 0.579-29.485; P=.16).

conclusionsWe observed a nonstatistically significant preservation of renal function in patients with obesity who underwent OPN at 3 to 6 months postoperatively. Conversely, after 6 months, the same was true for MIPN, indicating the long-term benefit of MIPN. In the nonobese group, MIPN was favored over OPN.

Indexed as

cancerkidneylong-termminimally invasive vs open partial nephrectomyobesityoutcomerenal cell carcinomarenal outcomesretrospectiveshort-termsurgery

Identifiers

PMID35006078
PMCPMC8787657

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.