OBJECTIVES: This study evaluates the feasibility and safety of open-partial nephrectomies in the ZIRK-technique (Zero @entity63 Resection in the Kidney) for renal masses with high-risk anatomical features--objectified by the PADUA score. METHODS: We identified 40 consecutive cases of partial nephrectomies performed without clamping of the renal artery in our department of urology. Retrospective analysis of the preoperative CT or MRI scans showed 27 cases with a PADUA score >= 8, of which 15 cases had a score >= 10. Cases were in particular assessed regarding operation time (ORT), estimated @entity190 (EBL), surgical margins and postoperative complications using the Clavien classification. RESULTS: The mean age of the study population was 67.6 years with an average BMI of 26.8 kg/m2. The mean ORT was 1:46 with an average EBL of 521 ml. Clavien @entity532 were observed seven times, while 3 @entity1 had a grade IIIa complication. Despite complex and adverse location of the @entity5 , nephron-sparing surgery without @entity63 could be performed with negative surgical margins for all cases. EBL, transfusion rate and complication were considerably more frequent in high-risk @entity5 . CONCLUSION: Highly complex @entity703 , PADUA >= 10, can be resected in ZIRK-technique with good operative outcome and a low complication rate.

ZIRK-Technique: Zero XXXX Resection in the Kidney for High-Risk Renal Masses: Perioperative Outcome.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity63 :: ('MESH:D007511', 'Disease') :: ['Ischemia', 'ischemia'] @entity190 :: ('MESH:D006473', 'Disease') :: ['blood loss'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumors'] @entity532 :: ('MESH:D003925', 'Disease') :: ['grade II complications'] @entity703 :: ('MESH:D007680', 'Disease') :: ['renal tumors']
@entity63 :: (MESH:D007511,Disease) :: ['Ischemia']
