Outcomes and Techniques of Robotic-Assisted Partial Nephrectomy (RAPN) for Renal Hilar Masses: A Comprehensive Systematic Review

Abstract

Background: Robot-assisted partial nephrectomy (RAPN) is increasingly being employed in the management of renal cell carcinoma (RCC) and it is expanding in the field of complex renal tumors. The aim of this systematic review was to consolidate and assess the results of RAPN when dealing with entirely central hilar masses and to examine the various methods used to address the surgical difficulties associated with them. Methods: A thorough literature search in September 2023 across various databases focused on RAPN for renal hilar masses, adhering to PRISMA guidelines. The primary goal was to evaluate RAPN’s surgical and functional outcomes, with a secondary aim of examining different surgical techniques. Out of 1250 records, 13 full-text manuscripts were reviewed. Results: Evidence is growing in favor of RAPN for renal hilar masses. Despite a predominance of retrospective studies and a lack of long-term data, RAPN shows positive surgical outcomes and preserves renal function without compromising cancer treatment effectiveness. Innovative suturing and clamping methods are emerging in surgical management. Conclusions: RAPN is a promising technique for managing renal hilar masses in RCC, offering effective surgical outcomes and renal function preservation. The study highlights the need for more long-term data and prospective studies to further validate these findings.

Perioperative and Oncological Outcomes of Percutaneous Radiofrequency Ablation versus Partial Nephrectomy for cT1a Renal Cancers: A Retrospective Study on Groups with Similar Clinical Characteristics

“…With the advancement in surgical techniques, the indications for RAPN are expanding to even more challenging tumours. Recently, RAPN was reported to offer encouraging results in the case of challenging perihilar masses [35].…”

Ablative Treatments for Small Renal Masses and Management of Recurrences: A Comprehensive Review

“…However, despite these recommendations, current literature still lacks randomized clinical trials comparing ablative techniques to NSS; indeed, only observational studies have been conducted for this purpose [9,23]. Nonetheless, on the one hand, previous studies suggest that the outcomes of ablative techniques are comparable to those of surgical resection, with a 5-year cancer-specific survival rate of 95%; on the other hand, it is crucial to note that the risk of local recurrence and metastasis tends to be more prevalent after focal ablations than after surgical approaches [24][25][26][27].…”