Comparison of robot‐assisted and open partial nephrectomy for completely endophytic renal tumours: a single centre experience

Abstract

For completely endophytic renal tumours, both OPN and RAPN have excellent outcomes when performed by experienced surgeons at a high-volume centre. For skilled robotic surgeons, RAPN is a safe and effective alternative to OPN with the advantages of shorter length of stay and less blood loss.

Are there limits of robotic partial nephrectomy? TRIFECTA outcomes of open and robotic partial nephrectomy for completely endophytic renal tumors

“…However, patients with RAPN had a higher CCI, whereas the fraction of patients with solitary kidney was higher in the OPN group. This reflects the findings of previous studies . Our analyses reflect recent findings of a multi‐institutional study, which observed comparable outcome of RAPN in low/intermediate and high‐risk tumors .…”

“…Most interestingly, many studies report lower complication rates for RAPN . These differences seem to diminish when it comes to endophytic tumors as the current and previous data suggest …”

“…Remarkably, positive surgical margins were not observed in any RAPN case and in two OPN cases only (2.6%). Hence, the current PSM rates are below the reported range of 3‐12% for endophytic tumors across both approaches and strengthen the evidence that both techniques may offer an oncologically save resection even in highly challenging tumors . The complication rates in this study are relatively high compared to previous studies most likely reflecting the unique patient selection .…”

“…Beside low conversion rates, the goal of PN should be complete tumor resection, no complication and preservation of renal function (TRIFECTA) . Although the feasibility of OPN and RAPN for endophytic tumors has been shown previously, there are limited data on the comparability of both approaches . Studies comparing OPN and RAPN for “complex” tumors often use a rather liberal cut‐off for defining “high complexity” which may not sufficiently consider the surgical challenge of entirely endophytic tumors .…”

“…Finally, failure in organ preservation and conversion to nephrectomy is still reported to be above 10% in robotic series . Although the feasibility of RAPN has been proven for entirely endophytic tumors, there is limited comparative data to OPN from single centers only . Therefore, the aim of this study is to compare the outcomes of RAPN and OPN from high‐volume Centers and to identify possible selection criteria.…”