910 ROBOT ASSISTED LAPAROSCOPIC PARTIAL NEPHRECTOMY FOR TUMORS GREATER THAN 4 CM: FEASIBILITY AND EARLY FUNCTIONAL OUTCOMES

Background. To compare the perioperative and functional outcomes between robot-assisted partial nephrectomy (RAPN) and laparoscopic partial nephrectomy (LPN) for giant sporadic renal angiomyolipomas (AMLs) of ≥7 cm. Materials and Methods. Patients with sporadic renal AMLs of ≥7 cm who underwent RAPN or LPN in the First Affiliated Hospital of Nanchang University between 2015 and 2020 were retrospectively analyzed. Propensity score matching (1 : 1) was performed to adjust for potential baseline confounders. Perioperative and functional outcomes of the RAPN and LPN groups were collected and compared. Result. After propensity score matching, no statistically significant differences in baseline characteristics were found between the groups (41 vs. 41). Within the matched cohort, the warm ischemia time (WIT) in the RAPN group was significantly shorter than that in the LPN group (21 vs. 27 min, p < 0.001 ). In addition, the RAPN group was associated with improved postoperative renal function (72.8 vs. 69.8 mL/min/1.73 m2, p = 0.045 ). WIT and preoperative renal function are independent predictors of renal function at 6 months postoperatively, and renal score and operation method are independent predictors of WIT. Conclusion. RAPN and LPN are safe and feasible minimally invasive treatments for sporadic giant renal AMLs, but RAPN is associated with shorter WIT and better postoperative renal functional preservation. WIT and preoperative renal function are independent predictors of renal function at 6 months postoperatively, while the RENAL score and surgical method are independent risk factors to WIT. For giant and complex renal AMLs, RAPN is the first choice when condition permits.

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A Comparison of Surgical and Functional Outcomes of Robot-Assisted Versus Pure Laparoscopic Partial Nephrectomy

JSLS Journal of the Society of Laparoendoscopic Surgeons ◽

10.4293/108680813x13693422521359 ◽

2013 ◽

Vol 17 (2) ◽

pp. 292-299 ◽

Cited By ~ 12

Author(s):

Jae Duck Choi ◽

Jong Wook Park ◽

Hye Won Lee ◽

Dong-Gi Lee ◽

Byong Chang Jeong ◽

...

Keyword(s):

Partial Nephrectomy ◽

Functional Outcomes ◽

Laparoscopic Partial Nephrectomy ◽

Robot Assisted

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Surgical and Functional Outcomes on Omitting Cortical Renorrhaphy During Robot-Assisted Versus Laparoscopic Partial Nephrectomy: A Match-Paired Analysis

10.21203/rs.3.rs-1191585/v1 ◽

2022 ◽

Author(s):

Masashi Kubota ◽

Toshinari Yamasaki ◽

Shiori Murata ◽

Yohei Abe ◽

Yoichiro Tohi ◽

...

Keyword(s):

Blood Loss ◽

Partial Nephrectomy ◽

Functional Outcomes ◽

Surgical Margin ◽

Laparoscopic Partial Nephrectomy ◽

Robot Assisted ◽

Ischemic Time ◽

Warm Ischemic Time ◽

Estimated Blood Loss ◽

Preservation Rate

Abstract Objectives To assess surgical and functional outcomes in comparison of cortical renorrhaphy omitting, robot-assisted partial nephrectomy (CRO-RAPN), and laparoscopic partial nephrectomy (CRO-LPN). Methods Between July 2012 and June 2020, patients with localized clinical T1-2 renal masses who underwent CRO-RAPN or CRO-LPN were reviewed. The outcomes of the CRO-RAPN and CRO-LPN groups were compared using propensity score matching. Trifecta was defined as negative surgical margin, less than 25 minutes of warm ischemic time, and no complications of Clavien-Dindo grade III or more until three months postoperatively. Preservation rate of the estimated glomerular filtration rate (eGFR) was evaluated at six months postoperatively. Results A total of 291 patients, including 210 patients who underwent CRO-RAPN and 81 patients who underwent CRO-LPN, were included, and matched pairs of 150 patients were analyzed. The CRO-RAPN group was associated with a significantly shorter warm ischemic time (13 min vs 20 min, P < 0.001), shorter total operation time (162 min vs 212 min, P < 0.001), less estimated blood loss (40 mL vs 119 mL, P = 0.002), lower incidence of overall complications (3% vs 16%, P = 0.001), higher preservation rate of eGFR at six months postoperatively (93% vs 89%, P = 0.003), and higher trifecta achievement rate (84% vs 64%, P = 0.004) than the CRO-LPN group. Conclusions CRO-RAPN contributes to a shorter warm ischemic time, less blood loss, fewer complications, and preservation of renal function and makes it feasible to achieve a higher rate of trifecta compared to CRO-LPN.

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