SIU 2017: Robotic Partial Nephrectomy for Complex Renal Lesions: Strategies for Success - A Multi-institutional Study

Lisbon, Portugal ( Due to their size, location and proximity to the hilum, some complex renal tumors may preclude a minimally invasive approach to nephron sparing surgery. The authors describe their technique of robotic partial nephrectomy for challenging complex renal tumors.

This is a study of 249 patients who underwent robotic partial nephrectomy (RPN) in multiple institutions. Patients were identified using a prospective RPN databases. A complex renal lesion was defined as a tumor with a RENAL nephrometry score > 10. 

Thirty-one (12.4%) of RPN were for complex renal tumors. Median age was 57 (50.5 - 70.5) years. Twenty-one (67.7%) were male, 10 (32.3%) were female. American Society of Anesthesiologists score was 2 (2 -3). Median operative time was 200 (50 - 265) min, median warm ischemia time was 23 (18.5-29) min, and median blood loss was 200 (50 - 265) ml. There were no intraoperative complications, but 2 (6.4%) of patients had post-operative complications. 1 (3.2%) patient had a positive margin. Length of stay was 3.5 (3-5) days. Median follow up was 12.5 (7 - 24) months, and there were no recurrences. RPN did result in statistical significant changes in renal function 3 months post RPN compared to preoperative renal function, p=0.0001.

The authors conclude that RPN is a safe approach for select patients with complex renal tumors, and may facilitate tumor resection and renorrhaphy for challenging cases.

Presented by: Derek Hennessey
Affiliation:  Dept. of Surgery, Austin Health, The University of Melbourne, Australia

Written by: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre.Twitter: @GoldbergHanan at the 37th Congress of Société Internationale d’Urologie - October 19-22, 2017- Lisbon, Portugal