Clinical advantages of robot‐assisted partial nephrectomy versus laparoscopic partial nephrectomy in terms of global and split renal functions: A propensity score‐matched comparative analysis

Kobayashi, Seiichiro; Mutaguchi, Jun; Kashiwagi, Eiji; Takeuchi, Ario; Shiota, Masaki; Inokuchi, Junichi; Eto, Masatoshi

doi:10.1111/iju.14525

Cited by 6 publications

(14 citation statements)

References 30 publications

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“…There were 31 studies included in the NMA [9,16,21,30–57]. This comprised of one RCT, four prospective studies and 26 retrospective studies (30 propensity score matching studies).…”

Section: Resultsmentioning

confidence: 99%

“…Publication dates ranged from 2008 to 2021. Study data from the 31 included studies are outlined in Table 1 [9,16,21,30–57]. Risk of bias assessment for the RCT included in this study is outlined in Appendix S1.…”

Section: Resultsmentioning

confidence: 99%

“…Such improvements in WIT likely reflect the technically challenging aspect of the laparoscopic approach. The shortened WIT in RAPN was shown to have an associated improvement in the preservation of renal function postoperatively in several studies, further highlighting the potential benefits of a robot‐assisted approach [16,37,38,44,51,60].…”

Section: Discussionmentioning

confidence: 99%

“…RAPN has been shown to share similar advantages as LPN over OPN (shorter hospital stay, reduced intraoperative blood loss) as well as comparable oncological outcomes [12,13]. Moreover, when compared to LPN, RAPN has been shown to have the added benefits of decreased WIT and better preserved postoperative renal function [14][15][16][17][18] whilst maintaining comparable short-term oncological and functional outcomes [19].…”

Section: Introductionmentioning

confidence: 99%

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Comparing the outcomes of open, laparoscopic and robot‐assisted partial nephrectomy: a network meta‐analysis

et al. 2023

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ObjectiveTo perform a systematic review and network meta‐analysis (NMA) to determine the advantages and disadvantages of open (OPN), laparoscopic (LPN), and robot‐assisted partial nephrectomy (RAPN) with particular attention to intraoperative, immediate postoperative, as well as longer‐term functional and oncological outcomes.MethodsA systematic review was performed as per the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses‐NMA guidelines. Binary data were compared using odds ratios (ORs). Mean differences (MDs) were used for continuous variables. ORs and MDs were extracted from the articles to compare the efficacy of the various surgical approaches. Statistical validity is guaranteed when the 95% credible interval does not include 1.ResultsIn total, there were 31 studies included in the NMA with a combined 7869 patients. Of these, 33.7% (2651/7869) underwent OPN, 20.8% (1636/7869) LPN, and 45.5% (3582/7689) RAPN. There was no difference for either LPN or RAPN as compared to OPN in ischaemia time, intraoperative complications, positive surgical margins, operative time or trifecta rate. The estimated blood loss (EBL), postoperative complications and length of stay were all significantly reduced in RAPN when compared with OPN. The outcomes of RAPN and LPN were largely similar except the significantly reduced EBL in RAPN.ConclusionThis systematic review and NMA suggests that RAPN is the preferable operative approach for patients undergoing surgery for lower‐staged RCC.

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“…There were 31 studies included in the NMA [9,16,21,30–57]. This comprised of one RCT, four prospective studies and 26 retrospective studies (30 propensity score matching studies).…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Comparing the outcomes of open, laparoscopic and robot‐assisted partial nephrectomy: a network meta‐analysis

et al. 2023

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“…The surgical approach for clinical T1 renal masses has shifted from radical nephrectomy to partial nephrectomy (PN) for preservation of renal function [1][2][3][4] . The original PN was an open approach that was oncologically and surgically effective and safe compared to radical nephrectomy [1][2][3] , yielding a signi cantly decreased rate of renal insu ciency 1,[2][3][4][5] .…”

Section: Introductionmentioning

confidence: 99%

Robotic Partial Nephrectomy Is Associated with a Significantly Decreased Rate of Postoperative Pseudoaneurysm Compared to Open and Laparoscopic Partial Nephrectomy

Mahmud,

Haitovic,

Zilberman

et al. 2024

Preprint

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Background: While partial nephrectomy offers oncologic efficacy and preserves renal function for T1 renal tumors, renal artery pseudoaneurysm (RAP) remains a rare but potentially life-threatening complication. This study compared RAP incidence across robotic-assisted (RAPN), laparoscopic (LPN), and open (OPN) partial nephrectomies in a large tertiary oncological center. Methods: This retrospective study analyzed 785 patients undergoing partial nephrectomy between 2012-2022 (398 RAPN, 122 LPN, 265 OPN). Data included demographics, tumor size/location, surgical type, clinical presentation, treatment, and post-operative outcomes. The primary outcome was RAP incidence, with secondary outcomes including presentation, treatment efficacy, and renal function. Results: Seventeen patients (2.1%) developed RAP, presenting with massive hematuria (100%), hemorrhagic shock (5.8%), and clot retention (23%). The median onset was 12 days postoperatively. RAP occurred in 4 (1%), 4 (3.3%), and 9 (3.4%) patients following RAPN, LPN, and OPN, respectively (p=0.04). Only surgery length and surgical approach were independently associated with RAP. Selective embolization achieved immediate bleeding control in 94%, with one patient requiring a second embolization. No additional surgery or nephrectomy was needed. Estimated GFR at one year was similar across both groups (p=0.53). Conclusions: RAPN demonstrated a significantly lower RAP incidence compared to LPN and OPN (p=0.04). Emergency angiographic embolization proved effective, with no long-term renal function impact. Limitations: This retrospective study lacked randomization and long-term follow-up. Further research with larger datasets and longer follow-up is warranted. Patient Summary:This study suggests that robotic-assisted partial nephrectomy is associated with a significantly lower risk of RAP compared to traditional approaches. Emergency embolization effectively treats RAP without compromising long-term renal function.

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Predicting estimated glomerular filtration rate after partial and radical nephrectomy based on split renal function measured by radionuclide: a large-scale retrospective study

Zheng,

Hou,

et al. 2023

World J Urol

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Purpose The purpose of this study was to develop predictive models for postoperative estimated glomerular filtration rate (eGFR) based on the split glomerular filtration rate measured by radionuclide (rGFR), as choosing radical nephrectomy (RN) or partial nephrectomy (PN) for complex renal masses requires accurate prediction of postoperative eGFR. Methods Patients who underwent RN or PN for a single renal mass at Xijing Hospital between 2008 and 2022 were retrospectively included. Preoperative split rGFR was evaluated using technetium-99 m-diethylenetriaminepentaacetic acid (Tc-99 m DTPA) renal dynamic imaging, and the postoperative short-term (< 7 days) and long-term (3 months to 5 years) eGFRs were assessed. Linear mixed-effect models were used to predict eGFRs, with marginal R2 reflecting predictive ability. Results After excluding patients with missing follow-up eGFRs, the data of 2251 (RN: 1286, PN: 965) and 2447 (RN: 1417, PN: 1030) patients were respectively included in the long-term and short-term models. Two models were established to predict long-term eGFRs after RN (marginal R2 = 0.554) and PN (marginal R2 = 0.630), respectively. Two other models were established to predict short-term eGFRs after RN (marginal R2 = 0.692) and PN (marginal R2 = 0.656), respectively. In terms of long-term eGFRs, laparoscopic and robotic surgery were superior to open surgery in both PN and RN. Conclusions We developed novel tools for predicting short-term and long-term eGFRs after RN and PN based on split rGFR that can help in preoperative decision-making.

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Clinical advantages of robot‐assisted partial nephrectomy versus laparoscopic partial nephrectomy in terms of global and split renal functions: A propensity score‐matched comparative analysis

Cited by 6 publications

References 30 publications

Comparing the outcomes of open, laparoscopic and robot‐assisted partial nephrectomy: a network meta‐analysis

Comparing the outcomes of open, laparoscopic and robot‐assisted partial nephrectomy: a network meta‐analysis

Robotic Partial Nephrectomy Is Associated with a Significantly Decreased Rate of Postoperative Pseudoaneurysm Compared to Open and Laparoscopic Partial Nephrectomy

Predicting estimated glomerular filtration rate after partial and radical nephrectomy based on split renal function measured by radionuclide: a large-scale retrospective study

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