Comparison of surgical, functional, and oncological outcomes of open and robot-assisted partial nephrectomy

Abstract

BACKGROUND:We aimed to compare the surgical, oncological, and functional outcomes of robot-assisted partial nephrectomy (RAPN) with open partial nephrectomy (OPN) in the management of small renal masses.MATERIALS AND METHODS:Between 2009 and 2013, a total of 46 RAPN patients and 20 OPN patients was included in this study. Patients’ demographics, mean operative time, estimated blood loss (EBL), warm ischemia time (WIT), length of hospital stay, pre- and post-operative renal functions, complications and oncological outcomes were recorded, prospectively.RESULTS:Mean tumor size was 4.04 cm in OPN group and 3.56 cm in RAPN group (P = 0.27). Mean R.E.N.A.L nephrometry score was 6.35 in OPN group and 5.35 in RAPN group (P = 0.02). The mean operative time was 152 min in OPN group and 225 min in RAPN group (P = 0.006). The mean EBL in OPN and RAPN groups were 417 ml and 268 ml, respectively (P = 0.001). WIT in OPN group was significantly shorter than RAPN group (18.02 min vs. 23.33 min, P = 0.003). The mean drain removal time and the length of hospital stay were longer in OPN group. There were no significant differences in terms of renal functional outcomes and postoperative complications between groups.CONCLUSION:Minimally invasive surgical management of renal masses with RAPN offers better outcomes in terms of EBL and length of stay. However, the mean operative time and WIT were significantly shorter in OPN group. RAPN is a safe and effective minimally invasive alternative to OPN in terms of oncological and functional outcomes.

Comparison of perioperative, renal and oncologic outcomes in robotic‐assisted versus open partial nephrectomy

“…suggests reduced operative complications, EBL and length of hospital stay in RAPN . Recent studies reinforce these findings . Similarly, our study demonstrated with statistical significance a benefit of RAPN over OPN in these perioperative parameters.…”

“…These findings suggest RAPN is at least equivalent to OPN and favours its potential for renal preservation in more complex tumours. Furthermore, there was no significant difference in operation time between groups ( P = 0.16) despite our RAPN series accommodating the surgeons’ learning curve (i.e. the first 50 cases), suggesting early plateau of the RAPN learning gradient as proposed in earlier reports …”

Percutaneous Radiofrequency Ablation Versus Robotic-Assisted Partial Nephrectomy for the Treatment of Small Renal Cell Carcinoma

“…Open partial nephrectomy has long been considered the treatment of first choice for T1 small renal masses (SRMs) [ 18 ]. Recently, there has been a move towards less invasive procedures such as laparoscopic and robotic partial nephrectomy [ 19 , 20 ]. RPN seems to be the currently more widely used method, in experienced centres, due to the added benefits offered by the da Vinci robot (such as improved precision and decreased range of motion) leading to decreased warm ischaemic times [ 21 ].…”

A prospective, multi-institutional study of perioperative morbidities in the patients of renal cell carcinoma undergoing either open nephron sparing surgery or robotic nephron sparing surgery in fifty cases

“…Our results were similar to the study by several other authors viz. Boylu [21][22][23][24][25]27 This difference may be attributed due to complains of fever in the postoperative period in 8 (16%) patients and persistent drainage in another patient.…”