Long-term outcomes of minimally invasive surgeries in partial nephrectomy. Robot or laparoscopy?

Abstract

To compare long-term oncological and renal functional outcomes of laparoscopic and robotic partial nephrectomy for small renal masses. A total of 103 patients who underwent laparoscopic (n=31) and robotic (n=72) partial nephrectomy between April 2015 and November 2018 were included in the study. Perioperative parameters, long-term oncological and functional outcomes were compared between the laparoscopic and robotic groups. No significant differences were found in terms of age, tumour size, RENAL and PADUA scores, pre-operative estimated glomerular filtration rate (eGFR), and presence of chronic hypertension and diabetes (P=.479, P=.199, P=.120 and P=.073, P=.561, and P=.082 and P=.518, respectively). Only estimated blood loss was significantly higher in the laparoscopic group in operative parameters (158.23±72.24mL vs. 121.11±72.17mL; P=.019), but transfusion rates were similar between the groups (P=.33). In the laparoscopic group, two patients (6.5%) required conversion to open, while no conversion was needed in the robotic group (P=.89). There were no differences in terms of positive surgical margin and complication rates (P=.636 and P=.829, respectively). No significant differences were observed in eGFR changes and post-operative new-onset chronic kidney disease at 1year after the surgery (P=.768, P=.614, respectively). The overall mean follow-up period was 36.07±13.56months (P=.007). During the follow-up period, no cancer-related death observed in both group and non-cancer-specific survival was 93.5% and 94.4% in laparoscopic and robotic groups, respectively (P=.859). In this study, perioperative and long-term oncological and functional outcomes seems to be comparable between laparoscopic and robotic partial nephrectomies.