1532 Strict Trifecta Outcomes of Robotic-Assisted Partial Nephrectomy inT1a and T1b Renal Tumours

Abstract Aim To evaluate and compare strict Trifecta outcomes of robotic assisted partial nephrectomy (RAPN) in patients with T1a and T1b renal tumours. Method A retrospective analysis of 146 consecutive patients undergoing a robotic assisted partial nephrectomy for T1a and T1b renal tumours from 2014-2019. Patient demographics, tumour characteristics, strict trifecta measures including warm ischaemia time, minimal renal function change (≤15% postoperative eGFR decrease), complications, and surgical margin positivity were collected, as well as intra-operative and oncological outcomes. Results In total 146 patients underwent RAPN. 113 patients had T1a tumours, 30 had T1b with a mean tumour size of 2.5cm (0.8-3.9cm) and 4.5cm (4.1-7cm) respectively, and 3 patients had T2a tumours. The nephrometry score was higher in stage T1b patients, however all other variables were similar between the two stage groups. Overall strict Trifecta was 75.5% with 77.9% in T1a group compared to 66.7% in T1b group (p = 0.21). Postoperative renal function was preserved in 102 patients in T1a vs 26 patients in T1b. Approximately 9 patients with T1a had positive surgical margin compared to 3 patients in T1b cohort. Post-operatively 3 patients in T1b (10%) group developed a Clavien Dindo score of 3 complications, compared to none in the T1a group (p 0.009). These were due to pseudoaneurysm and bleeding. No statistical difference in Fuhrman score and tumour types in the two groups. No cancer recurrences were observed during the 30 months follow up period in both T1a and T1b groups. Conclusions RAPN is a feasible treatment choice in selected T1b renal tumours.

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Evaluation of Routine Postoperative Labs Following Robotic Assisted Partial Nephrectomy in Patients with Normal Preoperative Renal Function

Urology ◽

10.1016/j.urology.2021.11.012 ◽

2021 ◽

Author(s):

Amanda A Myers ◽

Laura E. Geldmaker ◽

Daniela A. Haehn ◽

Colleen T. Ball ◽

David D Thiel

Keyword(s):

Renal Function ◽

Partial Nephrectomy ◽

Robotic Assisted ◽

Robotic Assisted Partial Nephrectomy

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Complication rates and renal function after robotic-assisted partial nephrectomy in elderly vs young patients

European Urology Supplements ◽

10.1016/s1569-9056(18)33198-1 ◽

2018 ◽

Vol 17 (8) ◽

pp. 251-252

Author(s):

G. Primiceri ◽

M. Marchioni ◽

C. D’Orta ◽

A. Rizzoli ◽

P. Castellan ◽

...

Keyword(s):

Renal Function ◽

Partial Nephrectomy ◽

Young Patients ◽

Complication Rates ◽

Robotic Assisted ◽

Robotic Assisted Partial Nephrectomy

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Robotic assisted partial nephrectomy for T2 renal tumours

European Urology Supplements ◽

10.1016/s1569-9056(19)32729-0 ◽

2019 ◽

Vol 18 (6) ◽

pp. e2609-e2610

Author(s):

P. Penkoff ◽

P. Wisz ◽

A. Mottrie

Keyword(s):

Partial Nephrectomy ◽

Robotic Assisted ◽

Renal Tumours ◽

Robotic Assisted Partial Nephrectomy

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Associations between radiographic characteristics and change in renal function following partial nephrectomy using 24-hour creatinine clearance

Canadian Urological Association Journal ◽

10.5489/cuaj.559 ◽

2013 ◽

Vol 5 (1) ◽

pp. 45

Author(s):

Rodney H. Breau ◽

Aaron T.D. Clark ◽

Chris Morash ◽

Dean Fergusson ◽

Ilias Cagiannos

Keyword(s):

Renal Function ◽

Creatinine Clearance ◽

Partial Nephrectomy ◽

Tumour Size ◽

Multivariable Analysis ◽

Function Change ◽

Tumour Location ◽

Function Preservation ◽

The Mean ◽

The Impact

Background: Radiographic characteristics may be associated withthe degree of renal function preservation following partial nephrectomy.The purpose of this study was to determine the impact ofpreoperative radiographic variables on change in renal functionusing 24-hour urine creatinine clearance (uCrCl).Methods: Patients with partial nephrectomy performed fromNovember 2003 to 2008 were enrolled in the study. Serum creatinineand 24-hour urine was collected preoperatively and at3, 6 and 12 months postoperatively. Computed tomography ormagnetic resonance imaging was used to determine tumour size,tumour location and renal volume.Results: Of the 36 patients, median age was 62 (range 30-78) and21 (58%) were male. The mean tumour diameter was 2.8±1.4 cm.Twenty-two (61%) tumours were located at the renal pole and11 (31%) were endophytic. Overall, mean preoperative uCrClwas 88.8±34.2 mL/min and mean postoperative uCrCl was82.8±33.6 mL/min (6.8%; p < 0.01). On multivariable analysis,no single characteristic was associated with a clinically prohibitivedecrease in renal function (-9.4% if endophitic, p = 0.06; -0.57%per cm diameter, p = 0.73; and -6.9% if located at the renal pole,p = 0.15). The total renal volume was also not significantly associatedwith renal function change (-1.1% per 100 cc, p = 0.86).Interpretation: Preoperative radiographic characteristics seem tobe associated with small changes in renal function following partialnephrectomy. These data support renal functional benefits of partialnephrectomy regardless of tumour size and location.

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Trans-peritoneal vs. retroperitoneal robotic assisted partial nephrectomy in posterior renal tumours: need for a risk-stratified patient individualised approach. A systematic review and meta-analysis

Journal of Robotic Surgery ◽

10.1007/s11701-019-00973-8 ◽

2019 ◽

Vol 14 (1) ◽

pp. 1-9 ◽

Cited By ~ 2

Author(s):

Andrew McLean ◽

Ankur Mukherjee ◽

Chandan Phukan ◽

Rajan Veeratterapillay ◽

Naeem Soomro ◽

...

Keyword(s):

Systematic Review ◽

Partial Nephrectomy ◽

Meta Analysis ◽

Robotic Assisted ◽

Renal Tumours ◽

Robotic Assisted Partial Nephrectomy

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Comparison of robotic and laparoscopic partial nephrectomy for small renal tumours

Archivio Italiano di Urologia e Andrologia ◽

10.4081/aiua.2017.2.93 ◽

2017 ◽

Vol 89 (2) ◽

pp. 93 ◽

Cited By ~ 3

Author(s):

Abdulmuttalip Simsek ◽

Abdullah Hizir Yavuzsan ◽

Yunus Colakoglu ◽

Arda Atar ◽

Selcuk Sahin ◽

...

Keyword(s):

Partial Nephrectomy ◽

Functional Outcomes ◽

Surgical Margin ◽

Laparoscopic Partial Nephrectomy ◽

Positive Surgical Margin ◽

Robotic Partial Nephrectomy ◽

Asa Score ◽

Estimated Blood Loss ◽

Renal Tumours ◽

Significant Difference

Objective: To evaluate a single surgeon oncological and functional outcomes of laparoscopic partial nephrectomy (LPN) compared to robotic partial nephrectomy (RPN) for pT1a renal tumours. Materials and methods: Between 2006 and 2016, a retrospective review of 42 patients who underwent LPN (n = 20) or RPN (n = 22) by same surgeon was performed. Patients were matched for gender, age, body mass index (BMI), American Society of Anaesthesiologists (ASA) score, tumour side, RENAL and PADUA scores, peri-operative and post-operative outcomes. Results: There was no significant differences between the two groups with respect to patient gender, age, BMI, ASA score, tumours side, RENAL and PADUA scores. Mean operative time for RPN was 176 vs. 227 minutes for LPN (p = 0.001). Warm ischemia time was similar in both groups (p = 0.58). Estimated blood loss (EBL) was higher in the LPN. There was no significant difference with preoperative and postoperative creatinine and percent change in eGFR levels. Only one case in LPN had positive surgical margin. Conclusions: RPN is a developing procedure, and technically feasible and safe for small-size renal tumours. Moreover RPN is a comparable and alternative operation to LPN, providing equivalent oncological and functional outcomes, as well as saving more healthy marginal tissue and easier and faster suturing.

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