Surgical and functional outcomes of robot-assisted versus laparoscopic partial nephrectomy with cortical renorrhaphy omission

• Published in: Scientific reports Vol. 12; no. 1; p. 13000
• Main Authors: Kubota, Masashi, Yamasaki, Toshinari, Murata, Shiori, Abe, Yohei, Tohi, Yoichiro, Mine, Yuta, Hagimoto, Hiroki, Kokubun, Hidetoshi, Suzuki, Issei, Tsutsumi, Naofumi, Inoue, Koji, Kawakita, Mutsushi
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 29.07.2022; Nature Publishing Group; Nature Portfolio
• Subjects: 692/4025; 692/4028/546; 692/698/272/1684; Blood; Epidermal growth factor receptors; Glomerular filtration rate; Humanities and Social Sciences; Ischemia; Laparoscopy; multidisciplinary; Nephrectomy; Patients; Preservation; Renal function; Robotic surgery; Science; Science (multidisciplinary)
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-022-17496-2

To evaluate the surgical and functional outcomes between robot-assisted (CRO-RAPN) vs. laparoscopic (CRO-LPN) methods of cortical-renorrhaphy-omitting partial nephrectomy. Between July 2012 and June 2020, patients with localized clinical T1-2 renal masses who underwent CRO-RAPN or CRO-LPN were reviewed. The outcomes of the two groups were compared using propensity-score matching. Trifecta was defined as negative surgical margin, warm ischemic time < 25 min, and absence of complications of Clavien-Dindo grade III or more until three months postoperatively. The preservation rate of the estimated glomerular filtration rate (eGFR) was evaluated at six months postoperatively. Among 291 patients (CRO-RAPN, n = 210; CRO-LPN, n = 81) included in the study, 150 matched pairs of patients were analyzed. Compared to the CRO-LPN group, the CRO-RAPN group was associated with shorter warm ischemic time (13 min vs. 20 min, P  < 0.001), shorter total operation time (162 min vs. 212 min, P  < 0.001), less estimated blood loss (40 mL vs. 119 mL, P  = 0.002), lower incidence of overall complications (3% vs. 16%, P  = 0.001), higher preservation rate of eGFR at six months postoperatively (93% vs. 89%, P  = 0.003), and higher trifecta achievement rate (84% vs. 64%, P  = 0.004). CRO-RAPN contributed to shorter warm ischemic time, less blood loss, fewer complications, and higher preservation of renal function, all of which allowed this technique to achieve a higher rate of trifecta compared to CRO-LPN.