Robotic and open partial nephrectomy for intermediate and high complexity tumors: a matched-pairs comparison of surgical outcomes at a single institution

Abedali, Zain A.; Monn, M. Francesca; Huddleston, Patrick; Cleveland, Brent; Sulek, Jay; Bahler, Clinton D.; Foster, Richard S.; Koch, Michaël; Mellon, Matthew J.; Kaimakliotis, Hristos Z.; Cary, Clint; Bihrle, Richard; Gardner, Thomas A.; Masterson, Timothy A.; Boris, Ronald S.; Sundaram, Chandru P.

doi:10.1080/21681805.2020.1765017

Cited by 8 publications

(12 citation statements)

References 22 publications

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“…High-grade complications are commonly seen in OPN. 22,23 While Pazeto et al 25 noted similar results in high-grade complications between LPN and RPN, there was a significant reduction in low-grade complications in LPN.…”

Section: Complicationsmentioning

confidence: 92%

“…Multiple studies reported reduced EBL when performed via RPN approach. [20][21][22][23][24] 25 reported a higher EBL in RPN compared to LPN (225 ml vs 100 ml; p = 0.008). Our analysis demonstrated that LPN had a statistically lower EBL compared to RPN.…”

Section: Estimated Blood Lossmentioning

confidence: 94%

“…Most studies reported a lower WIT in MIS compared to open approach, with three studies favouring RPN. Abedali et al, 22 Bravi et al 24 and Larcher et al 34 reported statistical significance in WIT when performed via RPN compared to OPN and LPN. 22,24,34 Luciani et al 35 and Silagy et al 36 both reported a reduced mean WIT via OPN.…”

Section: Warm Ischaemia Timementioning

confidence: 97%

“…Abedali et al, 22 Bravi et al 24 and Larcher et al 34 reported statistical significance in WIT when performed via RPN compared to OPN and LPN. 22,24,34 Luciani et al 35 and Silagy et al 36 both reported a reduced mean WIT via OPN. Mearini et al 29 reported a lower WIT in LPN compared to OPN and RPN (0.8 min vs 3.3 min vs 1.3 min; p = 0.024).…”

Section: Warm Ischaemia Timementioning

confidence: 97%

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Perioperative outcomes between laparoscopic versus open versus robotic partial nephrectomy: Current Review

Wong,

Patel,

Biyani

2023

Urologia

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Background: Surgical treatment of small renal tumours remain gold-standard for individuals who are suitable candidates. Over the last decade, minimally invasive surgery has provided significant advancements within the field of urological surgery. However, there is still a debate on which surgical modality is superior. This study aims to review the current literature on perioperative outcomes between laparoscopic (LPN), open (OPN) and robotic-assisted partial nephrectomy (RPN) using the standardised system, Clavien-Dindo Classification (CDC). Methods: A literature search was performed on Cochrane, Embase and PubMed databases. Articles between January 2016 and December 2021 were included. Perioperative outcomes investigated include estimated blood loss (EBL), operating time (OT), conversion rate (CR), warm ischaemia time (WIT), positive surgical margin (PSM) and postoperative complications using CDC. Relevant pieces of literatures were analysed and data were extracted. Results: This study included 12 studies, with a total of 3908 patients. (LPN = 1120, OPN = 1206 and RPN = 1580). LPN demonstrated a lower overall EBL ( p = 0.004). There was no significant difference between OT ( p = 0.291), CR ( p = 0.200), WIT ( p = 0.760), PSM ( p = 0.549), CDC I ( p = 0.556), CDC II ( p = 0.779) and CDC⩾III ( p = 0.663) of the three surgical approaches. Conclusion: Compared with OPN and RPN, LPN demonstrated a lower EBL. All other perioperative outcomes demonstrated similar results between the three treatment modalities. Future large-scale, prospective, randomised studies is necessary to draw a definitive conclusion from this analysis.

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Section: Complicationsmentioning

confidence: 92%

Section: Estimated Blood Lossmentioning

confidence: 94%

Section: Warm Ischaemia Timementioning

confidence: 97%

Section: Warm Ischaemia Timementioning

confidence: 97%

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Perioperative outcomes between laparoscopic versus open versus robotic partial nephrectomy: Current Review

Wong,

Patel,

Biyani

2023

Urologia

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“…After abstract and title screening, 861 articles were excluded and remaining 33 articles underwent full-text review. After full-text review, 11 articles were excluded due to lack of individualized data on perioperative outcomes for complex renal masses, for final analysis 22 studies were included[ 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 ]. Out of these 22 studies, 11 studies were included for quantitative data synthesis and all the 22 studies were included for narrative and pooled analysis [ Figure 1 ].…”

Section: Introductionmentioning

confidence: 99%

Robot-assisted partial nephrectomy for moderate to highly complex renal masses. A systematic review and meta-analysis

Sharma

Tyagi

et al. 2022

Indian Journal of Urology

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Introduction: Multiple studies have been published recently assessing feasibility of robot-assisted partial nephrectomy (RAPN) for moderate to highly complex renal masses. Some studies have even compared partial nephrectomy (PN) performed through various modalities such as open PN (OPN) versus RAPN and laparoscopic PN (LPN) versus OPN. The primary aim of this review was to analyze perioperative outcomes such as warm ischemia time (WIT), duration of surgery, estimated blood loss (EBL), complications, blood transfusion, length of stay, and margin status following RAPN for complex renal masses. Another objective was to compare perioperative outcomes following various surgical modalities, i.e., OPN, LPN, or RAPN. Methods: Literature search was conducted to identify studies reporting perioperative outcomes following RAPN for moderate (Radius, Endophytic/Exophytic, Nearness, Anterior/posterior location [RENAL] score 7–9 or Preoperative Aspects of Dimension used for anatomic classification [PADUA] score 8–9) to high complexity renal masses (RENAL or PADUA score ≥ 10). Meta-analysis of robotic versus OPN and robotic versus LPN was also performed. Study protocol was registered with PROPSERO (CRD42019121259). Results: In this review, 22 studies including 2,659 patients were included. Mean duration of surgery, WIT, and EBL was 132.5–250.8 min, 15.5–30 min, and 100–321 ml, respectively. From pooled analysis, positive surgical margin, need for blood transfusion, minor and major complications were seen in 3.9%, 5.2%, 19.3%, and 6.3% of the patients. No significant difference was noted between RAPN and LPN for any of the perioperative outcomes. Compared to OPN, RAPN had significantly lower EBL, complications rate, and need for transfusion. Conclusions: RAPN for moderate to high complexity renal masses is associated with acceptable perioperative outcomes. LPN and RAPN were equal in terms of perioperative outcomes for complex masses whereas, OPN had significantly higher blood loss, complications rate, and need for transfusion as compared to RAPN.

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Partial Nephrectomy in the Treatment of RCC

Basin,

Sager,

Bhat

et al. 2023

Integrating Multidisciplinary Treatment for Advanced Renal Cell Carcinoma

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Robotic and open partial nephrectomy for intermediate and high complexity tumors: a matched-pairs comparison of surgical outcomes at a single institution

Cited by 8 publications

References 22 publications

Perioperative outcomes between laparoscopic versus open versus robotic partial nephrectomy: Current Review

Perioperative outcomes between laparoscopic versus open versus robotic partial nephrectomy: Current Review

Robot-assisted partial nephrectomy for moderate to highly complex renal masses. A systematic review and meta-analysis

Partial Nephrectomy in the Treatment of RCC

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