You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy I (PD12)1 Sep 2021PD12-08 GREATER RENAL FUNCTION BENEFIT FROM ENUCLEATION TECHNIQUE FOR MORE COMPLEX RENAL TUMORS IN ROBOT-ASSISTED PARTIAL NEPHRECTOMY Yudai Ishiyama, Tsunenori Kondo, Hidekazu Tachibana, Kazunari Tanabe, Kazuhiko Yoshida, Toshio Takagi, Junpei Iizuka, and Kazunari Tanabe Yudai IshiyamaYudai Ishiyama More articles by this author , Tsunenori KondoTsunenori Kondo More articles by this author , Hidekazu TachibanaHidekazu Tachibana More articles by this author , Kazunari TanabeKazunari Tanabe More articles by this author , Kazuhiko YoshidaKazuhiko Yoshida More articles by this author , Toshio TakagiToshio Takagi More articles by this author , Junpei IizukaJunpei Iizuka More articles by this author , and Kazunari TanabeKazunari Tanabe More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001987.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Tumor enucleation technique in robot-assisted partial nephrectomy (RAPN) reportedly contributes to renal function preservation. Which tumors to and which part to utilize this technique have not been determined. METHODS: This multi-institutional retrospective study included patients who underwent RAPN at tertiary surgery centers. Patients were first stratified into high, intermediate, and low groups based on renal nephrometry score. Patients were further classified into I/B-enucleation (I/B-E, I+B≤1) and I/B-resection (I/B-R, I+B≥2) groups based on surface-intermediate-base margin score. Perioperative outcomes, including percentile change in estimated glomerular filtration rate (eGFR), new-onset chronic kidney disease, complication rate, surgical margin, and trifecta achievement, were compared between the I/B-E and I/B-R groups in each classification. Odds ratios and β-coefficients were also compared. RESULTS: Overall, 704 patients were included in this study. Relative decrease in eGFR was significantly lower for the I/B-E group in all three classifications, with medians of 8.1%, 4.4%, and 3.2% in the high, intermediate, and low groups, respectively. In multivariate analyses, excision technique was independently associated with eGFR change in all three. β-coefficient was higher in the high (4.82) than in the low (3.14) or intermediate group (3.41). Across all three classifications, significantly more patients attained trifecta with difference of 34.0%, 18.9%, and 14.7% in the high, intermediate, and low groups, respectively (all, p <0.05), with odds ratio higher in the high (5.71) than in the intermediate (2.49) or low group (3.09). No significant differences were found in operation time, amount of estimated blood loss, rate of positive surgical margin, or complications. Warm ischemic time was significantly longer for the I/B-E group in the intermediate (18.0 vs. 16.0, p=0.002) and low groups (13.0 vs. 11.0, p=0.006), but not significant in the high group (p=0.344). CONCLUSIONS: I/B-enucleation in RAPN contributes to renal function preservation, and the impact was more emphasized in complex tumors. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e205-e206 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Yudai Ishiyama More articles by this author Tsunenori Kondo More articles by this author Hidekazu Tachibana More articles by this author Kazunari Tanabe More articles by this author Kazuhiko Yoshida More articles by this author Toshio Takagi More articles by this author Junpei Iizuka More articles by this author Kazunari Tanabe More articles by this author Expand All Advertisement Loading ...