MP42-04 MODIFIED ROBOT-ASSISTED SIMPLE ENUCLEATION WITH SINGLE LAYER RENORRHAPHY TECHNIQUE VERSUS STANDARD ROBOT-ASSISTED PARTIAL NEPHRECTOMY FOR TREATING LOCALIZED RENAL CELL CARCINOMA

Abstract

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy IV1 Apr 2018MP42-04 MODIFIED ROBOT-ASSISTED SIMPLE ENUCLEATION WITH SINGLE LAYER RENORRHAPHY TECHNIQUE VERSUS STANDARD ROBOT-ASSISTED PARTIAL NEPHRECTOMY FOR TREATING LOCALIZED RENAL CELL CARCINOMA Xiaozhi Zhao, Qun Lu, Rong Yang, Guangxiang Liu, Feng Qu, Xiaogong Li, Weidong Gan, and Hongqian Guo Xiaozhi ZhaoXiaozhi Zhao More articles by this author , Qun LuQun Lu More articles by this author , Rong YangRong Yang More articles by this author , Guangxiang LiuGuangxiang Liu More articles by this author , Feng QuFeng Qu More articles by this author , Xiaogong LiXiaogong Li More articles by this author , Weidong GanWeidong Gan More articles by this author , and Hongqian GuoHongqian Guo More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1311AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Nephron-sparing surgery is the gold standard treatment for localized renal masses. Simple enucleation has proven to be oncologically safe. In this study, we used our large institutional experience to compare perioperative results and early oncological outcomes with modified robot-assisted simple enucleation (MRASE) and robot-assisted partial nephrectomy (RAPN) for treating localized renal tumors. METHODS We evaluated 445 consecutive patients who underwent MRASE or RAPN for renal tumors in our institution from September 2014 to July 2017 in terms of perioperative pathologic and oncologic outcome variables. In simple enucleation, the surgeon used the pseudocapsule as the anatomical landmark to enucleate the tumor by blunt dissection, with no visible rim of normal parenchyma. The single layer suture technique was performed for renal reconstruction. RESULTS In total, 310 patients underwent MRASE and 135 underwent RAPN. Mean operative time was 181.3 and 192.3 min, respectively (p=0.038). Warm ischemic time was significantly lower in the MRASE than RAPN group (20.9 vs 24.3 min; p=0.000). The estimated blood loss was similar (p=0.381). Tumor bed suturing was performed in 8.7% and 79.3% of MRASE and RAPN cases (P=0.000). No hilar clamping was performed in 42 MRASE patients (13.5%) and 8 RAPN patients (5.9%) (p=0.019). Grade III and IV complications were reported in 6 (1.9%) MRASE patients and 9 (6.7%) RAPN patients (p=0.024). The incidence of positive surgical margins was comparable between the MRASE and RAPN groups (1.9% and 5.2%, p= 0.118). After a median follow-up of 18 months, recurrence did not differ between the 2 groups: 9 (2.9%) MRASE patients and 5 (3.7%) RAPN patients (p=0.881). CONCLUSIONS MRASE may confer shorter warm ischemic time, almost no need for tumor bed suturing and less Grade III and IV complications than RAPN, with similar oncologic outcomes. MRASE may be safe and acceptable for patients undergoing partial nephrectomy. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e537 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Xiaozhi Zhao More articles by this author Qun Lu More articles by this author Rong Yang More articles by this author Guangxiang Liu More articles by this author Feng Qu More articles by this author Xiaogong Li More articles by this author Weidong Gan More articles by this author Hongqian Guo More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...