Outcomes following Robotic Radical Nephrectomy: A Single-Center Experience

Dogra, Prem Nath; Abrol, Nitin; Singh, Prabhjot; Gupta, Narmada P.

doi:10.1159/000336627

Cited by 14 publications

(3 citation statements)

References 20 publications

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“…The highest number of conversions to ON is reported in the study of Dogra et al [10]; the primary reason for conversion was bleeding in all these cases.…”

Section: Discussionmentioning

confidence: 98%

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Robotic radical nephrectomy for renal cell carcinoma: a systematic review

et al. 2014

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BackgroundLaparoscopic radical nephrectomy (LRN) is the actual gold-standard for the treatment of clinically localized renal cell carcinoma (RCC) (cT1-2 with no indications for nephron-sparing surgery). Limited evidence is currently available on the role of robotics in the field of radical nephrectomy. The aim of the current study was to provide a systematic review of the current evidence on the role of robotic radical nephrectomy (RRN) and to analyze the comparative studies between RRN and open nephrectomy (ON)/LRN.MethodsA Medline search was performed between 2000–2013 with the terms “robotic radical nephrectomy”, “robot-assisted laparoscopic nephrectomy”, “radical nephrectomy”. Six RRN case-series and four comparative studies between RRN and (ON)/pure or hand-assisted LRN were identified.ResultsCurrent literature produces a low level of evidence for RRN in the treatment of RCC, with only one prospective study available. Mean operative time (OT) ranges between 127.8-345 min, mean estimated blood loss (EBL) ranges between 100–273.6 ml, and mean hospital stay (HS) ranges between 1.2-4.3 days. The comparison between RRN and LRN showed no differences in the evaluated outcomes except for a longer OT for RRN as evidenced in two studies. Significantly higher direct costs and costs of the disposable instruments were also observed for RRN. The comparison between RRN and ON showed that ON is characterized by shorter OT but higher EBL, higher need of postoperative analgesics and longer HS.ConclusionsNo advantage of robotics over standard laparoscopy for the treatment of clinically localized RCC was evidenced. Promising preliminary results on oncologic efficacy of RRN have been published on the T3a-b disease. Fields of wider application of robotics should be researched where indications for open surgery still persist.

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“…The highest number of conversions to ON is reported in the study of Dogra et al [10]; the primary reason for conversion was bleeding in all these cases.…”

Section: Discussionmentioning

confidence: 98%

“…Furthermore, in case of conversion for significant vascular complications, the initial part of the surgery has to be managed by the bed-side assistant, before the main surgeon scrubs in [10,11]. …”

Section: Discussionmentioning

confidence: 99%

Robotic radical nephrectomy for renal cell carcinoma: a systematic review

et al. 2014

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“…Some reports demonstrated that robotic RN and robotic partial nephrectomy are feasible and safe procedures with good oncological outcome [18,19]. Further experience is needed to validate the RENAL score in patients who undergo robotic surgery.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the RENAL Nephrometry Scoring System in Adopting Nephron-Sparing Surgery for cT1 Renal Cancer

et al. 2012

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Objective: The RENAL nephrometry scoring system characterizes tumors according to their size, growth pattern, location and nearness to the renal sinus or collecting system. The current study aims to evaluate the RENAL nephrometry scoring system in adopting nephron-sparing surgery (NSS) for cT1 renal cancer. Methods: Clinicopathological data of 200 consecutive patients who had undergone radical nephrectomy (RN) or NSS for clinical stage T1 renal cell cancer at our single institution during 2005-2009 were investigated retrospectively. Results: Of 200 patients, 103 were scheduled for RN, whereas 97 were planned to undergo NSS, 9 of whom actually underwent RN. Those who were planned to undergo NSS were younger and had smaller tumors (p < 0.001). The median RENAL score was significantly lower among those who were originally assigned to NSS (5, range 4-10) versus RN (8, range 4-11) (p < 0.001). Three months after surgery, the renal function of patients who had been scheduled for NSS was significantly better than in those treated by RN (p < 0.001). Conclusions: This study suggests that the RENAL nephrometry scoring system is a useful tool in adopting NSS for cT1 renal cancer and that objective decision-making for NSS was possible.

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