TAIPEI, TAIWAN (UroToday.com) - Introduction and Objectives: Robotic assisted laparoscopic partial nephrectomy (RPN) is becoming the standard of care in the management of small renal masses. We aimed to evaluate the safety, efficacy, and oncologic outcome of RALPN for clinical T1b renal masses.
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Methods: 119 patients who underwent robotic partial nephrectomy by a single surgeon at our institution from 2011 to 2014 were retrospectively reviewed Perioperative parameters and demographic data for clinical T1a and T1b (21 patients) masses were obtained from chart review and compared using Student’s t-test and Fisher’s exact test.
Results: For clinical T1b patients tumor size (5.3 cm vs. 2.3 cm, p < 0.0001) R.E.N.A.L nephrometry score (6.8 vs. 5.4, p = 0.009), and previous abdominal surgery (29 % vs. 86 % p < 0.0001) were all significantly different. Perioperative parameters that were statistically significant were operative time (242 min vs. 203 min, p = 0.010) and length of hospital stay (4.1 vs. 3.5 d, p = 0.002). There was one positive margin in T1b group compared to none T1a group. Inability to complete robotic partial in the T1b cohort was 25% vs. 7% in the T1a cohort (p = 0.030) including difference in conversion to open partial 19% vs. 6.1% (p = 0.050). There was greater percentage of Clavien I-III complications in the T1b cohort (24% vs. 9% p = 0.055).
Conclusions: RPN for patients with cT1b renal masses is safe and efficacious. Operative time and hospital stay were longer for patients with cT1b masses as well as need to convert to open partial nephrectomy. When counseling patients with cT1b renal masses, RPN should be considered a feasible option.
Source of Funding: None
|View an interview with Timothy Tran, one of the authors of this study.|
Presented by Andrew Leone, Timothy Tran, George Turini, Joseph Renzulli, Gyan Pareek, and Dragan Golijanin at the 32nd World Congress of Endourology & SWL - September 3 - 7, 2014 - Taipei, Taiwan
Alpert Medical School at Brown University, Division of Minimally Invasive Urology, Providence, RI USA