Comparisons of the safety and effectiveness of robot-assisted versus laparoscopic partial nephrectomy for central renal angiomyolipomas: A propensity score-matched analysis

Abstract

OBJECTIVE: To compare the safety and effectiveness of robot-assisted partial nephrectomy (RAPN) versus laparoscopic partial nephrectomy (LPN) in the treatment of central renal angiomyolipomas (AMLs). METHODS: We retrospectively analyzed the clinical data of 103 patients who were treated with either RAPN or LPN for central renal angiomyolipomas between January 2017 and June 2022. Propensity scores were matched according to sex, age, laterality, body mass index (BMI), symptoms, diameter of tumor, location of tumor distribution, RENAL score, preoperative hemoglobin, preoperative serum creatinine, preoperative glomerular filtration rate (eGFR), chronic disease, previous abdominal surgery, preoperative SAE, ASA score, and duration of follow-up, and after matching, perioperative and prognostic data of the two groups were compared. RESULTS: A total of 57 patients underwent RAPN, and 46 patients underwent LPN. Before matching, there were more complex AMLs in the RAPN group, and RENAL scores differed between the two groups (10 versus 9, P<0.001). After matching, the median warm ischemic time (WIT) in the RAPN group was significantly shorter than that in the LPN group (21.5 min versus 28 min, P=0.034), while the median operating time in the RAPN group was longer than that in the LPN group (190 min versus 160 min, P=0.02). The other indicators were not significantly different between the groups. CONCLUSION: RAPN has a shorter warm ischemia time but a longer operating time for central renal angiomyolipomas. RAPN did not show superiority over LPN in terms of safety and effectiveness; it is safe and feasible to apply either surgical approach in the treatment of central renal angiomyolipomas.