Robotic‐assisted laparoscopic tumor enucleation is a feasible technique for renal hilar tumors: A retrospective study

Abstract

Background and Objective This study aimed to evaluate the safety and efficacy of robot‐assisted laparoscopic tumor enucleation (RAE) for the treatment of renal hilar tumors and to describe our experience with renorrhaphy‐related surgical techniques. Methods Retrospective data were collected from 173 consecutive patients who underwent RAE for localized renal tumors (cT1–cT2N0M0) at our hospital between September 2014 and November 2019. Results Seventy‐five patients had renal hilar tumors and 98 patients had nonhilar tumors. There were no statistical differences between the hilar and nonhilar groups in operation time (190 [115–390] vs. 190 [110–390] min, p = 0.889), warm ischemia time (26 [12–60] vs. 27 [17–41] min, p = 0.257), hospital stay duration (8 [3–16] vs. 7.5 [4–18] days, p = 0.386), renal function (estimated glomerular filtration rate, 102.5 [29.4–144] vs. 101.3 [64.2–134.7] ml/min/1.73 m2, p = 0.631); creatinine level, (76 [43–169] vs. 78.5 [50–281.3] µmol/L, p = 0.673), perioperative complications rate, or surgical margin status. However, patients with hilar tumors lost significantly more blood than did those with nonhilar tumors (250 [50–1500] vs. 200 [20–1200] ml, p = 0.007). During the follow‐up period (median, 30 months), three patients in each group experienced recurrence. The 5‐year recurrence‐free rates were 93.0% and 95.4% in the hilar and nonhilar tumor groups, respectively (p = 0.640). Conclusions For experienced robot laparoscopists, RAE is a safe, effective, and feasible procedure for renal hilar tumors, without increased risk of positive surgical margins or worse midterm oncologic outcomes compared with nonhilar tumors.

Perioperative, oncologic, and functional outcomes of robot-assisted partial nephrectomy for special types of renal tumors (hilar, endophytic, or cystic): an evidence-based analysis of comparative outcomes

“…Furthermore, our subgroup analysis also demonstrated that the three subgroups had no statistically significant differences in PSM compared to the non-complex tumor group (p = 0.35; p = 0.18; p = 0.76) ( Figure 8 ). Similarly, no statistically significant difference in recurrence was found between the two groups (11 studies; p = 0.43) ( Figure 9 ) ( 17 , 18 , 20 , 21 , 23 – 30 ), and the subgroup analysis also illustrated no significant difference between the three subgroups and the non-complex group (p = 0.28; p = 0.16; p = 0.23). In terms of trifecta achievement, the pooled results revealed no difference between the two groups (seven studies; p = 0.05) ( Figure 9 ) ( 17 , 22 – 25 , 27 , 28 ).…”

“…No statistically significant difference in intraoperative complications was observed between the two groups (seven studies; p = 0.49) (Figure S4) (23-25, 27-30). However, the complex group had more major complications compared to the non-complex group (12 studies; OR 2.35, 95% CI 1.50 to 3.67, p = 0.0002) (18)(19)(20)(22)(23)(24)(25)(26)(27)(28)(29)(30), while the subgroup analysis revealed that no significant difference in major complications between renal hilar and nonhilar tumors (p = 0.18) (Figure 5). Overall complications occurred in 27.9% (207 of 743 cases) of patients in the complex group and 20.0% (480 of 2439 cases) of patients in the non-complex group.…”

“…no statistically significant difference in recurrence was found between the two groups (11 studies; p = 0.43) (Figure 9) (17, 18,20,21,[23][24][25][26][27][28][29][30], and the subgroup analysis also illustrated no significant difference between the three subgroups and the noncomplex group (p = 0.28; p = 0.16; p = 0.23). In terms of trifecta achievement, the pooled results revealed no difference between the two groups (seven studies; p = 0.05) (Figure 9) (17, 22-25, 27, 28).…”

Adjuvant chemotherapy or no adjuvant chemotherapy? A prediction model for the risk stratification of recurrence or metastasis of nasopharyngeal carcinoma combining MRI radiomics with clinical factors

“…3-year CSS was 90.8% in the training cohort and 81% in the validation cohort (P > 0.05). The characteristics of these patients are shown in Table 1 and Fig 2 [ 27 – 29 ].…”