Comparison of robotic and laparoscopic partial nephrectomy for small renal tumours

Şimşek, Abdülmuttalip; Yavuzsan, Abdullah Hızır; Çolakoğlu, Yunus; Atar, Arda; Şahin, Selçuk; Tuğcu, Volkan

doi:10.4081/aiua.2017.2.93

Cited by 7 publications

(3 citation statements)

References 16 publications

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“… 7 Several studies have shown that surgeons can achieve better perioperative outcomes in kidney surgery when treating tumors with robot-assisted partial nephrectomy (RAPN), a technically easier procedure than LPN. 8 , 9 …”

Section: Introductionmentioning

confidence: 99%

Trifecta Outcomes to Assess Learning Curve of Robotic Partial Nephrectomy

Omidele

Davoudzadeh

Palese

2018

JSLS

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Background and Objectives:The learning curve for achieving desirable perioperative outcomes in robot-assisted partial nephrectomy (RAPN) has not been well studied. Information is available regarding “trifecta” outcomes of no complications, no positive margins, warm ischemia time (WIT) of ≤25 minutes, and a ≤15% decrease in postoperative glomerular filtration rate (GFR). This study was conducted to assess the impact of the learning curve on surgical outcomes in patients undergoing RAPN.Methods:We reviewed 131 consecutive patients who underwent RAPN by a single, fellowship-trained surgeon from October 2007 through June 2015. Patients were divided into 4 subgroups, and mean perioperative values were compared. The learning curve was evaluated as the time it took the surgeon to attain a trifecta outcome.Results:Means for the RENAL Nephrometry Score, procedure length, WIT, and estimated blood loss (EBL) were 5.3 ± 1.2, 172.1 ± 43.5 minutes, 22.7 ± 7.0 minutes, and 267.2 ± 341.8 mL, respectively. Significance was noted for differences in WIT (P = .50), postoperative creatinine (P = .006), postoperative estimated (e)GFR (P = .40), and percentage change in creatinine (P = .023). The learning curve for achieving positive outcomes was noted in >61–90 cases after 66–80 months of performing minimally invasive partial nephrectomy surgeries at a rate of 20 cases per year.Conclusion:RAPN is a safe, feasible procedure with slightly better surgical outcomes than laparoscopic partial nephrectomy (LPN). In the hands of an experienced surgeon, the learning curve for achieving trifecta outcomes can involve a significant number of cases over several years.

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Section: Introductionmentioning

confidence: 99%

Trifecta Outcomes to Assess Learning Curve of Robotic Partial Nephrectomy

Omidele

Davoudzadeh

Palese

2018

JSLS

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“…From the perspective of surgical intervention for kidney cancer, patients with early T stage cancer would have a larger volume of healthy renal parenchyma for renal preservation, which might result in a better clinical outcome [ 20 ]. For partial nephrectomy, outcomes are more favorable for robotic surgery than for laparoscopic surgery in terms of a lower conversion rate to radical nephrectomy, favorable retention of renal function, and shorter warm ischemia time [ 21 – 23 ]. These features could partially explain the role of health expenditure in the MIR of kidney cancer.…”

Section: Discussionmentioning

confidence: 99%

Favorable mortality-to-incidence ratios of kidney Cancer are associated with advanced health care systems

et al. 2018

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BackgroundThe advancements in cancer therapy have improved the clinical outcomes of cancer patients in recent decades. However, advanced cancer therapy is expensive and requires good health care systems. For kidney cancer, no studies have yet established an association between clinical outcome and health care disparities.MethodsWe used the mortality-to-incidence ratio (MIR) for kidney cancer as a marker of clinical outcome to compare World Health Organization (WHO) country rankings and total expenditures on health/gross domestic product (e/GDP) using linear regression analyses.ResultsWe included 57 countries based on data from the GLOBOCAN 2012 database. We found that more highly developed regions have higher crude and age-standardized rates of kidney cancer incidence and mortality, but a lower MIR, when compared to less developed regions. North America has the highest crude rates of incidence, but the lowest MIRs, whereas Africa has the highest MIRs. Furthermore, favorable MIRs are correlated with countries with good WHO rankings and high e/GDP expenditures (p < 0.001 and p = 0.013, respectively).ConclusionsKidney cancer MIRs are positively associated with the ranking of health care systems and health care expenditures.Electronic supplementary materialThe online version of this article (10.1186/s12885-018-4698-6) contains supplementary material, which is available to authorized users.

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“… 6 These technical advances decrease the technical difficulty associated with the critical portion of PN, including tumor dissection and pelvicaliceal renal reconstruction. 7 …”

Section: Introductionmentioning

confidence: 99%

Robot-Assisted Partial Nephrectomy with a New Robotic Surgical System: Feasibility and Perioperative Outcomes

Dong

Xie

et al. 2022

Journal of Endourology

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Purpose: The aim of this study was to evaluate the feasibility and safety of a novel robotic system (KD-SR-01) for partial nephrectomy. Methods: Seventeen patients with small renal masses (SRMs) (≤4 cm) underwent KD-SR-01 robotic partial nephrectomy (KD-RPN) from December 2020 to March 2021 in our institution. The operative outcomes and perioperative data, including clinical and histological data, were prospectively collected and analyzed. Results: In total, 10 men and 7 women, with a median age of 51 years, underwent KD-RPN. Four transperitoneal procedures and 13 retroperitoneal procedures were performed without conversion to open or conventional laparoscopic surgery. The docking time and robotic operative time were 3.3 and 68.6 minutes, respectively. The warm ischemia time was 16.9 minutes. No major intraoperative or postoperative complications (Clavien grade ≥III) occurred. The duration of postoperative hospital stay was 5 days. Pathologic examination revealed nine clear cell carcinoma, two papillary cell carcinoma, one oncocytoma, and five angiomyolipoma cases. All surgical margins were negative. The estimated glomerular filtration rate (eGFR) on the first postoperative day was significantly decreased compared with the preoperative eGFR (91.7 ± 12.9 mL/min vs 97.9 ± 10.7 mL/min, p = 0.036). However, no significant difference was observed between the preoperative eGFR and the value on the fourth postoperative day (95.7 ± 13.4 mL/min vs 97.9 ± 10.7 mL/min, p = 0.427). Conclusions: KD-RPN was safe and feasible for treatment of SRM. The early oncologic and functional outcomes were promising. Long-term follow-up and well-designed prospective comparative studies with the da Vinci ® platform are needed to corroborate these findings.

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Comparison of robotic and laparoscopic partial nephrectomy for small renal tumours

Cited by 7 publications

References 16 publications

Trifecta Outcomes to Assess Learning Curve of Robotic Partial Nephrectomy

Trifecta Outcomes to Assess Learning Curve of Robotic Partial Nephrectomy

Favorable mortality-to-incidence ratios of kidney Cancer are associated with advanced health care systems

Robot-Assisted Partial Nephrectomy with a New Robotic Surgical System: Feasibility and Perioperative Outcomes

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