MP42-18 PURE LAPAROSCOPIC VERSUS ROBOT-ASSISTED PARTIAL NEPHRECTOMY FOR CT1B RENAL TUMORS: A SINGLE TERTIARY CENTER EXPERIENCE

Abstract

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy IV1 Apr 2018MP42-18 PURE LAPAROSCOPIC VERSUS ROBOT-ASSISTED PARTIAL NEPHRECTOMY FOR CT1B RENAL TUMORS: A SINGLE TERTIARY CENTER EXPERIENCE Riccardo Bertolo, Cristian Fiori, Daniele Amparore, Ivano Morra, Michele Di Dio, Roberto Mario Scarpa, and Francesco Porpiglia Riccardo BertoloRiccardo Bertolo More articles by this author , Cristian FioriCristian Fiori More articles by this author , Daniele AmparoreDaniele Amparore More articles by this author , Ivano MorraIvano Morra More articles by this author , Michele Di DioMichele Di Dio More articles by this author , Roberto Mario ScarpaRoberto Mario Scarpa More articles by this author , and Francesco PorpigliaFrancesco Porpiglia More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1325AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Superiority of robotic over pure laparoscopic approach for Partial Nephrectomy (PN) is in favor of robotics in the latest publications. Matters of debate are challenging lesions that need further studies. The aim of the study was to evaluate and to compare perioperative results of laparoscopic PN (LPN) versus robot-assisted PN (RAPN) for clinical T1b renal tumors in a single-center database. METHODS Data of the 165 patients who underwent LPN (106) or RAPN (59) for cT1b renal tumors were extracted from our prospectively-maintained database for minimally-invasive renal surgery from 05/2004 to 03/2017. MIC achievement (Margins, Ischemia, Complications) was defined as simultaneous absence of perioperative complications, negative surgical margins and warm ischemia time (WIT) below 20 minutes. LPN interventions were performed at the end of surgeon’s learning curve for LPN; RAPNs were performed since the beginning of the learning curve of the surgeon for RAPN. RESULTS The two groups had comparable BMI, preoperative Hb, CrS and eGFR, clinical tumor diameter (52.8 + 24.5mm for NPL and 51.7 + 32.1mm for RAPN group) and PADUA score (median 9, IQR 8-11). No significant differences were found in terms of warm ischemia time (24.3 ± 12.8 vs 22.6 ± 12.0, LPN vs RAPN, respectively), estimated blood losses, intraoperative complications (4.0% vs 3.5%, LPN vs RAPN), postoperative complications (9.1% vs 8.9%, LPN vs RAPN), lenght of hospital stay (median 6, IQR 5-7 in both the approaches) and positive surgical margins rate (4.0% vs 1.7%, LPN vs RAPN). MIC was achieved in 44 cases (41.5%) in LPN group vs 39 cases (66.1%) in RAPN group (p=0.02), and WIT >20' caused failure to achieve MIC in 90.3% of NPL (56/62) and 85%(17/20) of RAPN. CONCLUSIONS Clinically T1b renal tumors suitable for nephron-sparing surgery can be safely treated by both LPN and RAPN. Transition to RAPN seems to be faster for a surgeon with laparoscopic expertise. Outcomes with robotic approach are comparable to those of pure laparoscopy since the beginning of the learning curve. RAPN allows for significantly higher rate of MIC achievement. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e544 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Riccardo Bertolo More articles by this author Cristian Fiori More articles by this author Daniele Amparore More articles by this author Ivano Morra More articles by this author Michele Di Dio More articles by this author Roberto Mario Scarpa More articles by this author Francesco Porpiglia More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...