Perioperative and long-term renal functional outcomes of robotic versus laparoscopic partial nephrectomy: a multicenter matched-pair comparison

Jeong Ho Kim, Yong Hyun Park, Yong June Kim, Seok Ho Kang, Seok Soo Byun, Cheol Kwak, Sung Hoo Hong

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Purpose: We compared perioperative and long-term renal functional outcomes of robot-assisted partial nephrectomy (RAPN) with laparoscopic partial nephrectomy (LPN) for small renal masses. Materials and methods: A total of 1,032 patients were included for evaluation; propensity score matching was performed to adjust for potential baseline confounders, which resulted in 195 LPNs matched to 195 RAPNs. Patient characteristics including preoperative estimated glomerular filtration rate (eGFR) were investigated, and postoperative results were evaluated. Results: No significant differences were found between the groups with regard to age, body mass index, sex distribution, preoperative eGFR, or tumor size. The mean follow-up period was 32.4 ± 21.1 months for LPN patients versus 31.1 ± 24.5 months for RAPN patients (p = 0.589). Operative time (p < 0.001) and warm ischemic time (p < 0.001) were significantly shorter in the RAPN group. No significant differences were observed in the overall change in eGFR (p = 0.768) or positive surgical margin rate (p = 0.653). A multivariate analysis showed that preoperative eGFR and hypertension significantly influenced the risk of stage 3 and 4 chronic kidney disease. A significant deterioration in renal function occurred 3 months after surgery. However, renal function increased gradually after the nadir eGFR was reached. The amount of renal functional recovery was higher in the RAPN group. Conclusions: Operative parameters for RAPN appear to be less affected by tumor complexity. Functional outcomes of RAPN were superior to those of LPN. Renal function recovered continuously during the 60-month follow-up period after partial nephrectomy.

Original languageEnglish
Pages (from-to)1579-1584
Number of pages6
JournalWorld Journal of Urology
Volume33
Issue number10
DOIs
Publication statusPublished - 2015 Oct 30

Keywords

  • Laparoscopy
  • Nephrectomy
  • Renal cell carcinoma
  • Robotics

ASJC Scopus subject areas

  • Urology

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