MP47-05 SUTURELESS OFF-CLAMP ROBOT-ASSISTED PARTIAL NEPHRECTOMY: INDICATION, FEASIBILITY AND FUNCTIONAL OUTCOMES

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You have accessJournal of UrologyCME1 Apr 2023MP47-05 SUTURELESS OFF-CLAMP ROBOT-ASSISTED PARTIAL NEPHRECTOMY: INDICATION, FEASIBILITY AND FUNCTIONAL OUTCOMES Riccardo Mastroianni, Gabriele Tuderti, Umberto Anceschi, Alfredo Maria Bove, Aldo Brassetti, Manuela Costantini, Simone D'annunzio, Mariaconsiglia Ferriero, Leonardo Misuraca, Andrea Iannuzzi, Alberto Ragusa, Rocco Papalia, Salvatore Guaglianone, and Giuseppe Simone Riccardo MastroianniRiccardo Mastroianni More articles by this author , Gabriele TudertiGabriele Tuderti More articles by this author , Umberto AnceschiUmberto Anceschi More articles by this author , Alfredo Maria BoveAlfredo Maria Bove More articles by this author , Aldo BrassettiAldo Brassetti More articles by this author , Manuela CostantiniManuela Costantini More articles by this author , Simone D'annunzioSimone D'annunzio More articles by this author , Mariaconsiglia FerrieroMariaconsiglia Ferriero More articles by this author , Leonardo MisuracaLeonardo Misuraca More articles by this author , Andrea IannuzziAndrea Iannuzzi More articles by this author , Alberto RagusaAlberto Ragusa More articles by this author , Rocco PapaliaRocco Papalia More articles by this author , Salvatore GuaglianoneSalvatore Guaglianone More articles by this author , and Giuseppe SimoneGiuseppe Simone More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003293.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Minimizing renal function loss during robot-assisted partial nephrectomy (RAPN) is a primary surgical outcome. There are few reports about sutureless RAPN and this procedure has intrinsic selection bias, being renorraphy a mandatory step to manage major bleeding sources and unintended urinary tract violation. The aim of this study was to describe predictors of performing renorraphy, and to compare perioperative and functional outcomes between sutureless and conventional renorraphy RAPN. METHODS: Our single center IRB approved renal cancer database was queried for “RAPN” and “renorraphy””. After a standardization process, all consecutive patients treated between Jan 2020 and May 2022 underwent off-clamp RAPN with a sutureless intent. Renal stump coagulation was used to control bleeding sources after RAPN. Intraoperative evidences of urinary tract violation was the only indication to perform renorraphy. Baseline and postoperative outcomes were collected. Continuous and categorical variables were compared using Mann-Whitney and Chi-Square tests. Logistic regression analysis was performed to identify predictors of renorraphy. Kaplan-Meier (KM) analysis and the log-rank test were performed to compare probabilities of developing newly onset chronic kidney disease (CKD) stage≥3 between cohorts. RESULTS: Out of 269 patients included, sutureless approach was successully completed in 246 patients. Both cohorts were homogeneous for baseline features except for PADUA score (p=0.028). No differences occurred postoperatively (Table 1). On multivariable analysis, nearness to collecting system ≤4mm was the only independent predictor of need for renorraphy (p=0.008 - Table 2). Overall, 108 patients had a renal tumor nearness ≤4mm to collecting system and sutureless intent failure probability was 16%. At KM analysis, performing renorraphy did not impact on probabilities of developning CKD stage ≥3 (2yrs: sutureless: 16.3%±2.9 vs renorraphy: 19.0%±10.5; p=0.71). CONCLUSIONS: Nearness to urinary collecting system predicts probability of performing renorraphy, which had negligible impact on perioperative and early functional outcomes. Safety, feasibility and functional outcomes of sutureless RAPN were confirmed, even if larger cohorts and randomized controlled trials are needed to obtain stronger evidences. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e644 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Riccardo Mastroianni More articles by this author Gabriele Tuderti More articles by this author Umberto Anceschi More articles by this author Alfredo Maria Bove More articles by this author Aldo Brassetti More articles by this author Manuela Costantini More articles by this author Simone D'annunzio More articles by this author Mariaconsiglia Ferriero More articles by this author Leonardo Misuraca More articles by this author Andrea Iannuzzi More articles by this author Alberto Ragusa More articles by this author Rocco Papalia More articles by this author Salvatore Guaglianone More articles by this author Giuseppe Simone More articles by this author Expand All Advertisement PDF downloadLoading ...