PD02-04 DOES ROBOT-ASSISTED APPROACH IMPROVE MORBIDITY AND SURGICAL OUTCOMES AFTER PARTIAL NEPHRECTOMY IN OBESE PATIENT (ROBESE STUDY NCT03293563)

Abstract

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy I (PD02)1 Apr 2020PD02-04 DOES ROBOT-ASSISTED APPROACH IMPROVE MORBIDITY AND SURGICAL OUTCOMES AFTER PARTIAL NEPHRECTOMY IN OBESE PATIENT (ROBESE STUDY NCT03293563) Jean Baptiste Beauval*, Arnaud Mejean, Nicolas Doumerc, Morgan Roupret, Francois Xavier Nouhaud, Philippe Paparel, Cedric Lebacle, Jean Alexandre Long, Mathieu Durand, Charles Dariane, Romain Boissier, Franck Bruyère, Alexandre de la Taille, Karim Bensalah, and Jean Christophe Bernhard Jean Baptiste Beauval*Jean Baptiste Beauval* More articles by this author , Arnaud MejeanArnaud Mejean More articles by this author , Nicolas DoumercNicolas Doumerc More articles by this author , Morgan RoupretMorgan Roupret More articles by this author , Francois Xavier NouhaudFrancois Xavier Nouhaud More articles by this author , Philippe PaparelPhilippe Paparel More articles by this author , Cedric LebacleCedric Lebacle More articles by this author , Jean Alexandre LongJean Alexandre Long More articles by this author , Mathieu DurandMathieu Durand More articles by this author , Charles DarianeCharles Dariane More articles by this author , Romain BoissierRomain Boissier More articles by this author , Franck BruyèreFranck Bruyère More articles by this author , Alexandre de la TailleAlexandre de la Taille More articles by this author , Karim BensalahKarim Bensalah More articles by this author , and Jean Christophe BernhardJean Christophe Bernhard More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000822.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Obesity is a public health problem in industrialized countries and is a known risk factor for kidney cancer.At the same time, partial nephrectomy has become the gold standard in the management of kidney tumors and minimally invasive (robot-assisted) surgery has been established to improve peri-operative morbidity. Recently, some teams have noted that robot-assisted renal surgery overcomes the surgical difficulties associated with excessive BMI.To study the peri and postoperative morbidity of robotic partial nephrectomy (RPN) in obese patients (BMI> 30Kg/m2) METHODS: Prospective cohort study of 20 UroCCR centers from 2009 to 2017. Descriptive analysis of the population and comparison with a control group: open partial nephrectomy (OPN) for patients BMI> 30. Quantitative variables were described with mean, standard deviation, median, quartile interval and min-max. For the qualitative variables, they have been described with numbers and percentages. The tests were chi two test, Fischer test and Mc Nemar test (Qualitative) and student test (Quantitative). For the survival analysis, a survival model of Aalen Johansen to consider the competitive risk (Rstudio version 1.1.463). RESULTS: 669 patients had BMI> 30Kg/m2 (480 RPN vs 189 OPN, median 32.4Kg/m2 (30.1-62.4) with a median follow-up of 36 months. 2% of the patients had an ASA of 2 and 72.9% an ECOG of 0. No statistical difference between RPN and OPN was found on the variables of complexity and tumor size (median 3.8cm). The rate of per, postoperative medical and surgical complications was statistically significantly lower after RPN (5.5 vs 11%, 13.2 vs 20% and 3.8 vs 15% respectively). LoS and blood loss was lower after RPN (3.8 vs 8.1d and 305 vs 426ml respectively). Trifecta and clamp duration were not statistically different (63 vs 65%, 18.9 vs. 19.6min respectively). The distribution of preoperative DFG was similar in the 2 groups and the variations after surgery were similar in the 2 groups (93 vs 88% and 98 vs 97% at 3 years). CONCLUSIONS: RPN in obese patients reduced morbidity vs OPN (BMI> 30 Kg /m2) and can be considered as the standard in obese patient for PN.There was impact no impact on survival with no local recurrence or same mortality rate.Too few people to conclude on patients with morbid obesity (BMI>35) Source of Funding: none © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e67-e67 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jean Baptiste Beauval* More articles by this author Arnaud Mejean More articles by this author Nicolas Doumerc More articles by this author Morgan Roupret More articles by this author Francois Xavier Nouhaud More articles by this author Philippe Paparel More articles by this author Cedric Lebacle More articles by this author Jean Alexandre Long More articles by this author Mathieu Durand More articles by this author Charles Dariane More articles by this author Romain Boissier More articles by this author Franck Bruyère More articles by this author Alexandre de la Taille More articles by this author Karim Bensalah More articles by this author Jean Christophe Bernhard More articles by this author Expand All Advertisement PDF downloadLoading ...