Demirtas’ early renal vascular control technique (DERVACT): A novel technique for open partial nephrectomy

Year 2022, Volume: 39 Issue: 1, 51 - 55, 01.01.2022

Gökhan Sönmez Şevket Tolga Tombul Türev Demirtaş Abdullah Gölbaşı Abdullah Demirtas

Abstract

“Demirtas’ Early Renal Vascular Control Technique (DERVACT)” is a novel technique for renal pedicle control that aims to achieve rapid and direct access to the renal artery through the retroperitoneal space and then the superior-dorso-lateral aspect of the kidney. In this study, we aimed to introduce DERVACT and to present the initial outcomes of this technique. This retrospective-observational study compared two groups of patients that were operatively treated by the same surgical team using two different nephron sparing surgery (NSS) procedures. Group I (n=95) underwent standard open NSS and Group II (n=92) underwent open NSS with the DERVACT between Jan 2015 and July 2020. Mean age was 56.42 ± 13.27 years. No significant difference was found between the two groups with regard to age, gender, Body mass index, mass laterality and size, and the Padua and c-index scores (p=0.087, p=0.354, p=0.642, p=0.957, p=0.200, p=0.101, p=0.361, respectively). Similarly, no significant difference was found between the DERVACT group and the other group with regard to ischemia duration (20.0 [15.0-30.0] min vs. 18.5 [11.0-27.0] min, respectively, p=0.060) and intraoperative vascular complication rate (6.3% vs. 1.1%, respectively. p=0.059). However, non-ischemic operative time was significantly shorter in the DERVACT group than in the standard partial nephrectomy group (64.0 [50.0-75.0] vs. 84.0 [61.0-105.0], p<0.001). As a conclusion, DERVACT is a simple, time-saving, and safe procedure for NSS that can be used in clinics with no opportunities for robotic-laparoscopic partial nephrectomy or in open partial nephrectomy.

Keywords

kidney surgery, retroperitoneal approach, vascular anatomy, partial nephrectomy

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