Robotic and laparoscopic partial nephrectomy for T1b tumors

Abstract

Laparoscopic and robotic-assisted partial nephrectomy have been widely adopted for the management of small renal masses; however, usage in T1b (greater than 4 cm) lesions is less established. Herein, we report a review on the published series of minimally invasive partial nephrectomies for such renal masses. Several institutions have described laparoscopic and robotic-assisted partial nephrectomy as a safe management option for pathologic T1b lesions. The oncologic results are promising, with low positive margin rates and few cases of progressive disease. Longer-term renal dysfunction does not appear at an increasing rate in this cohort of patients. The safety profile appears acceptable; however, there is a slightly increased rate of complications in these cohorts of patients. Laparoscopic and robotic-assisted partial nephrectomy is a well tolerated and viable option for performing minimally invasive surgical extirpation of cT1b renal masses. The oncologic and functional results are excellent with acceptable safety profiles. In patients with such masses minimally invasive partial nephrectomy should be considered for elective and absolute indications. In order to achieve excellent functional and oncologic outcomes with minimal perioperative complications an experienced surgeon with assistant and assessment of tumor with patient comorbidities are important.