ArticleCancers2022
On-Clamp vs. Off-Clamp Robot-Assisted Partial Nephrectomy for cT2 Renal Tumors: Retrospective Propensity-Score-Matched Multicenter Outcome Analysis.
Article in Cancers, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed.
- Multidisciplinary perioperative management of robot-assisted renal surgery: practical considerations for partial nephrectomy and nephroureterectomy.Journal of robotic surgery · 2026Review
- Off-Clamp Versus On-Clamp Partial Nephrectomy: An Updated Systematic Review, Meta-Analysis and Meta-Regression.Journal of clinical medicine · 2026Review
- Review
- Article
- Comparative outcomes of retroperitoneal partial nephrectomy for cT1 and cT2 renal tumors: a single-center experience.BMC urology · 2025Article
- Predictors of postoperative infectious complications after partial nephrectomy: Analysis at a referral institution.Asian journal of urology · 2025Article
- Three-dimensional visualization techniques improve surgical Decision Making of robotic-assisted partial nephrectomy.Heliyon · 2024Article
- Impact of No-Clamping Partial Nephrectomy on Early Estimated Glomerular Filtration Rate Preservation.Journal of clinical medicine · 2024Article
- On-clamp vs off-clamp robot-assisted partial nephrectomy for achieving modified trifecta: inverse probability of treatment weighting analysis from a high-volume tertiary robotic center.Journal of robotic surgery · 2024Article
- Off-clamp robotic partial nephrectomy is a safe and effective approach for patients with T1b or greater renal tumors.Journal of robotic surgery · 2024Article
- Comparison of Perioperative, Functional, and Oncologic Outcomes of Open vs. Robot-Assisted Off-Clamp Partial Nephrectomy: A Propensity Scored Match Analysis.Sensors (Basel, Switzerland) · 2024Article
- Skill Transfer from Laparoscopic Partial Nephrectomy to the Hugo™ RAS System: A Novel Proficiency Score to Assess Surgical Quality during the Learning Curve.Journal of clinical medicine · 2024Article
- Comparing Perioperative Complications of Off-Clamp versus On-Clamp Partial Nephrectomy for Renal Cancer Using a Novel Energy Balancing Weights Method.Life (Basel, Switzerland) · 2024Article
- Off-clamp Versus On-clamp Robot-assisted Partial Nephrectomy: A Systematic Review and Quantitative Synthesis by the European Association of Urology Young Academic Urologists Renal Cancer Study Group.European urology open science · 2023Review
- The Association of Ischemia Type and Duration with Acute Kidney Injury after Robot-Assisted Partial Nephrectomy.Current oncology (Toronto, Ont.) · 2023Article
- Robot-Assisted Renal Surgery with the New Hugo Ras System: Trocar Placement and Docking Settings.Journal of personalized medicine · 2023Article
- Review
- Perioperative, Functional, and Oncologic Outcomes of On-Clamp Versus Off-Clamp Partial Nephrectomy: An Updated Meta-analysis of 9027 Patients.Urology research & practice · 2023Article
- Article
- Purely Off-Clamp Laparoscopic Partial Nephrectomy Stands the Test of Time: 15 Years Functional and Oncologic Outcomes from a Single Center Experience.Current oncology (Toronto, Ont.) · 2023Article
Corrections and comments
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Authors and funding
32 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
We compared perioperative outcomes after on-clamp versus off-clamp robot-assisted partial nephrectomy (RAPN) for >7 cm renal masses. A multicenter dataset was queried for patients who had undergone RAPN for a cT2cN0cM0 kidney tumor from July 2007 to February 2022. The Trifecta achievement (negative surgical margins, no severe complications, and ≤ 30% postoperative estimated glomerular filtration rate (eGFR) reduction) was considered a surrogate of surgical quality. Overall, 316 cases were included in the analysis, and 58% achieved the Trifecta. A propensity-score-matched analysis generated two cohorts of 89 patients homogeneous for age, ASA score, preoperative eGFR, and RENAL score (all p > 0.21). Compared to the on-clamp approach, OT was significantly shorter in the off-clamp group (80 vs. 190 min; p < 0.001), the incidence of sRFD was lower (22% vs. 40%; p = 0.01), and the Trifecta rate higher (66% vs. 46%; p = 0.01). In a crude analysis, >20 min of hilar clamping was associated with a significantly higher risk of sRFD (OR: 2.30; 95%CI: 1.13−4.64; p = 0.02) and with reduced probabilities of achieving the Trifecta (OR: 0.46; 95%CI: 0.27−0.79; p = 0.004). Purely off-clamp RAPN seems to be a safe and viable option to treat cT2 renal masses and may outperform the on-clamp approach regarding perioperative surgical outcomes.
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Registered trials
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