Purely off‐clamp robotic partial nephrectomy: Preliminary 3‐year oncological and functional outcomes

Abstract

To describe our surgical technique and to report perioperative, 3-year oncological and functional outcomes of a single-center series of purely off-clamp robotic partial nephrectomy. A prospective renal cancer institutional database was queried, and data of consecutive patients treated with purely off-clamp robotic partial nephrectomy between 2010 and 2015 in a high-volume center were collected. Perioperative complications, and 3-year oncological and functional outcomes were assessed. Univariable and multivariable analyses were carried out to identify independent predictors of renal function deterioration. Out of 308 patients treated, 41 (13.3%) experienced perioperative complications, 2.9% of which were Clavien grade≥3. The 3-year local recurrence-free survival and renal cell carcinoma-specific survival rates were 99.5% and 97.9%, respectively. No patient with preoperative chronic kidney disease stage≤3B developed severe renal function deterioration (chronic kidney disease stage4) at 1-year follow up. At multivariable analysis, preoperative estimated glomerular filtration rate (P=0.005) was the only independent predictor of a new-onset chronic kidney disease stage≥3 in patients with preoperative chronic kidney disease stages1 or 2. Off-clamp robotic partial nephrectomy is a safe surgical approach in tertiary referral centers, with adequate oncological outcomes and negligible impact on renal function.