We compared the outcomes of robotic-assisted partial nephrectomy (RPN) and open partial nephrectomy (OPN) using contemporary data to respond to unmet clinical needs. Data from patients included in the registry who underwent partial nephrectomy between January 01, 2014 and June 30, 2017 within 20 centres of the French Network for Research on Kidney Cancer UroCCR were collected (NCT03293563). Statistical methods included adjusted multivariable analyses. Rates of peri- and post-operative transfusion, and of surgical revision, were lower in the RPN (n = 1434) than the OPN (n = 571) group (2.9% vs. 6.0%, p = 0.0012; 3.8% vs. 11.5%, p < 0.0001; 2.4% vs. 6.7%, p < 0.0001, respectively). In multivariable analyses, RPN was independently associated with fewer early post-operative complications than OPN (overall: odds-ratio [95% confidence interval, CI] = 0.48 [0.35-0.66]; severe: 0.29 [0.16-0.54], p < 0.0001 for both) and shorter hospital stays (34% [30%; 37%], p < 0.0001). RPN was also a significantly associated with a decresedrisk of post-operative acute renal failure, and new-onset chronic kidney disease at 3 and 12 months post-surgery. There were no between-group differences in oncological outcomes. In comparison with OPN, RPN was associated with improved peri- and post-operative morbidity, better functional outcomes, and shorter hospital stays. Our results support the use of RPN, even for large and complex tumours.
Scientific reports. 2022 Nov 08*** epublish ***
A Ingels, K Bensalah, J B Beauval, P Paparel, M Rouprêt, H Lang, F X Nouhaud, F Hénon, F Bruyère, F Audenet, C Lebacle, H Baumert, J A Long, R Tambwe, T Charles, E Xylinas, T Waeckel, C Michiels, J Asselineau, A Bénard, G Margue, R Boissier, P Bigot, J C Bernhard, Comité Cancer de l’Association Francaise d’Urologie (CCAFU)
Department of Urology, University Hospital Henri Mondor, APHP, Créteil, France. ., Department of Urology, Rennes University Hospital, Rennes, France., Department of Urology, University Hospital Rangueil, Toulouse, France., Department of Urology, Lyon Sud Hospital, HCL, Pierre-Bénite, France., Department of Urology, Pitié-Salpêtrière Hospital, Sorbonne University, APHP, Paris, France., Department of Urology, University Hospital of Strasbourg, Strasbourg, France., Department of Urology, Rouen University Hospital, Rouen, France., Department of Urology, Lille University Hospital, Lille, France., Department of Urology, Tours University Hospital, Tours, France., Department of Urology, Hôpital Européen Georges Pompidou, APHP, Paris, France., Department of Urology, Bicêtre University Hospital, APHP, Le Kremlin Bicêtre, France., Department of Urology, Paris Saint-Joseph Hospital, Paris, France., Department of Urology, Grenoble University Hospital, Grenoble, France., Department of Urology, Reims University Hospital, Reims, France., Department of Urology, Poitiers University Hospital, Poitiers, France., Department of Urology, Bichat-Claude Bernard Hospital, APHP, Paris, France., Department of Urology, Caen University Hospital, Caen, France., Department of Urology, Hôpital Pellegrin, Bordeaux University Hospital, Bordeaux, France., Clinical Epidemiology Unit (USMR), CHU Bordeaux, 33000, Bordeaux, France., Department of Urology and Renal Transplantation, La Conception University Hospital, APHM, Marseille, France., Department of Urology, Angers University Hospital, Angers, France.