Clinical research of robot-assisted laparoscopic partial nephrectomy in solitary kidney

Abstract

Objective To investigate the perioperative outcomes of robot-assisted laparoscopic partial nephrectomy in solitary kidney. Methods From September 2014 to September 2015, 9 patients underwent robot-assisted laparoscopic partial nephrectomy in solitary kidney. 6 of these patients were male, while the others were female. The average age of these patients was 60 years, ranged from 46-78 years. The lesion was located in left kidney of 5 cases, and the remaining in right kidney. The average diameter of lesion was 4.5 cm, ranged from 2.8-7.6 cm. One case was congenital solitary kidney, one was contralateral atrophic kidney, 2 cases were performed nephrectomy due to benign lesion, 5 cases were performed radical nephrectomy due to malignancy. All the cases were performed by robot-assisted laparoscopic surgery transperitoneally. Results The surgery of all 9 cases were successfully completed, and no conversion to open surgery. The median operation time was 104-215 min, with an average of 129 min. The estimated blood loss was 50-350 ml, with an average of 120 ml, and there was no blood transfusion. The warm ischemia time was 10-28 min, with an average of 18 min. There was no intraoperative complication occurred. The postoperative length of hospitalization was 8-17 d, with an average of 12 d. One case of urine leakage and another one of secondary hemorrhage were found after operation. The drainage tube and urinary catheter were removed in 3-5 days postoperation. The pathology analysis confirmed that 7 cases were renal clear cell carcinoma, one case was papillary carcinoma and one was angiomyolipoma, the tumor surgical margin was negative in all cases. The follow up duration was 1-12months, no recurrence or metastasis occurred. Conclusions Robot-assisted partial nephrectomy represents a safe and effective minimally-invasive treatment option for kidney neoplasms in patients with a solitary kidney, which provided reliable cancer control and renal function preservation. Key words: Robot; Lapsroscopy; Kidney neoplasms; Partial nephrectomy