MP49-03 THE SUPERIOR PRESERVATION OF POSTOPERATIVE RENAL FUNCTION IN ROBOTIC PARTIAL NEPHRECTOMY, COMPARED WITH THE LAPAROSCOPIC PROCEDURE, IS ASSOCIATED WITH LESS PARENCHYMAL VOLUME LOSS, NOT SHORTER RENAL ISCHEMIA TIME: A PROPENSITY SCORE-MATCHED ANALYSIS

Abstract

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy II1 Apr 2017MP49-03 THE SUPERIOR PRESERVATION OF POSTOPERATIVE RENAL FUNCTION IN ROBOTIC PARTIAL NEPHRECTOMY, COMPARED WITH THE LAPAROSCOPIC PROCEDURE, IS ASSOCIATED WITH LESS PARENCHYMAL VOLUME LOSS, NOT SHORTER RENAL ISCHEMIA TIME: A PROPENSITY SCORE-MATCHED ANALYSIS Hidekazu Tachibana, Toshio Takagi, Tsunenori Kondo, and Kazunari Tanabe Hidekazu TachibanaHidekazu Tachibana More articles by this author , Toshio TakagiToshio Takagi More articles by this author , Tsunenori KondoTsunenori Kondo More articles by this author , and Kazunari TanabeKazunari Tanabe More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1505AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Robot-assisted partial nephrectomy (RAPN) is reportedly superior to laparoscopic partial nephrectomy (LPN) in renal function preservation. This is partly due to the shortened warm ischemia time (WIT), but related evidence remains unclear. This study aimed to examine the cause of renal functional loss after minimally invasive partial nephrectomy. METHODS A total of 273 patients underwent LPN (n = 141) or RAPN (n = 132) at a single institution between 2010 and 2015. The factors influencing the >10% decrease in the estimated glomerular filtration rate (eGFR) 6 months postoperatively were evaluated, and the percentage of decrease in eGFR and parenchymal volume were compared in LPN and RAPN matched cohorts. RESULTS The mean WIT was significantly longer (24 vs. 18 minutes, p < 0.001) and the postoperative decrease in eGFR 6 months after surgery was significantly higher (-9.9% and -3.4%, p < 0.001) in LPN than in RAPN. Multivariate analysis showed that the >10% postoperative decrease in eGFR was significantly influenced by the surgical procedure (p = 0.0004), but not by WIT (p = 0.07). Patient variables, including age, sex, body mass index, tumor size, RENAL nephrometry score (RENAL-NS), preoperative eGFR, and WIT, were adjusted, and each group included 42 patients (mean tumor size 23 mm, RENAL-NS 6.4, preoperative eGFR 69 mL/min/1.73 m2, WIT 21 minutes). Six months after surgery, the percentage of decrease in eGFR (-9.4% vs. -1.9%, p = 0.0008) and parenchymal volume (-23% vs. -9%, p < 0.0001) was significantly higher in LPN than in RAPN. CONCLUSIONS The better preservation of renal function in RAPN, compared with LPN, is not caused by shortened WIT but by better preservation of parenchymal volume. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e647 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Hidekazu Tachibana More articles by this author Toshio Takagi More articles by this author Tsunenori Kondo More articles by this author Kazunari Tanabe More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...