BACKGROUND AND OBJECTIVES: Robot-assisted partial nephrectomy (RAPN) is emerging as an alternative to laparoscopic partial nephrectomy (LPN) for the treatment of small renal tumors.
We compare the results of LPN and RAPN performed by a single surgeon.
METHODS: Data from 100 consecutive patients who underwent LPN (n=52) or RAPN (n=48) performed by a single experienced laparoscopic surgeon between October 2007 and June 2010 were analyzed retrospectively. Perioperative data, including clinical, pathological, and functional outcomes, were compared between the LPN and RAPN groups.
RESULTS: No significant differences were found between groups with regard to mean estimated blood loss, main operation time, warm ischemic time, intraoperative complications, postoperative complications, hospital stay, or percent reduction of hemoglobin. The mean duration of follow-up was 16.2 months for LPN patients versus 8.9 months for RAPN patients (P< .001). With respect to the clamping method, more artery-only clamping occurred during RAPN than LPN (38.5 vs 75%, respectively, P=.001). The mean pathological tumor volume for LPN was 4.0 cm3 vs 8.2 cm3 for RAPN (P=.006). The mean resected healthy tissue volume was 25.1 cm3 for LPN versus 16.1 cm3 for RAPN (P=.044). There were no significant differences in positive margins or changes in renal function between the 2 cohorts.
CONCLUSION: RAPN is a comparable and alternative option to LPN, providing equivalent oncological and functional outcomes, as well as comparable morbidity to LPN. Although RAPN could offer the advantages of saving more healthy marginal tissue, longer-term and larger studies are necessary to evaluate the functional advantages.
Written by:
Choi JD, Park JW, Lee HW, Lee DG, Jeong BC, Jeon SS, Lee HM, Choi HY, Seo SI. Are you the author?
Department of Urology, KEPCO Medical Center, Seoul, Republic of Korea.
Reference: JSLS. 2013 Apr-Jun;17(2):292-9.
doi: 10.4293/108680813X13693422521359
PubMed Abstract
PMID: 23925024
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