AUA 2018: Pure Laparoscopic Versus Robot-Assisted Partial Nephrectomy for Ct1b Renal Tumors: A Single Tertiary Center Experience

San Francisco, CA USA (UroToday.com) Dr. Bertolo, from the University of Turin focused on the surgical management of renal cancer with two different partial nephrectomy techniques, laparoscopic partial nephrectomy (LPN) and robotic-assisted partial nephrectomy (RAPN). He suggested that recent literature has shown a superiority in robotic versus laparoscopic surgery, however debates arise around challenging cases. They sought to shed light on this issue by evaluating peri-operative results of LPN versus RAPN for T1b renal tumors.

This was a retrospective single center study that included 106 LPN and 59 RAPN for cT1b renal tumors between 2004-2017. The goal of the surgery was MIC achievement defined as negative Margins, Ischemia time below 20 minutes, and no Complications. The surgeons were experts in LPN, but due to the availability of the robotic equipment at the time of the study, surgeons were at the beginning of the learning curve for RAPN.

The patient demographics were similar as was tumor size, warm ischemia time, estimated blood loss, complications and length of hospital stay. However, RAPN had a higher MIC achievement rate compared to LPN (66.1% vs. 41.5%, p = 0.02). Failure to achieve MIC was primarily due to warm ischemia being greater than 20 min in 90.3% of LPN and 85% RAPN cases.

Dr. Bertolo concluded that T1b tumors can be safely managed with either LPN or RAPN. Furthermore, MIC achievement is higher with RAPN even at the beginning of the learning curve.

Presented by: Riccardo Bertolo, MD

Written by: Egor Parkhomenko, Department of Urology, University of California-Irvine at the 2018 AUA Annual Meeting - May 18 - 21, 2018 – San Francisco, CA USA

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