Comparison of robotic and open partial nephrectomy: Single-surgeon matched cohort study

Abstract

Results: There was no significant difference between the 2 cohorts with respect to patient age, BMI, ASA score, preoperative glomerular filtration rate, tumour size and the R.E.N.A.L. nephrometry score. The mean operative time was longer in the RPN group, but there were no significant differences with respect to warm ischemic time and postoperative renal function. The length of hospitalization and use of postoperative analgesics (ketoprofen) were more favourable in the RPN cohort. There was no significant difference in the mean estimated blood loss, transfusion rate, or complications between the cohorts. Conclusions: Considering the perioperative and postoperative parameters, RPN is a viable option as a nephron-sparing surgical procedure for small renal masses that yields outcomes comparable to those achieved with OPN. Despite matched cohort analysis among patients who underwent PN by a single surgeon, there may be inherent selection bias; therefore future prospective trials are needed.

Open versus robot‐assisted partial nephrectomy: A longitudinal comparison of 880 patients over 10 years

“…Only blood loss was no longer statistically significant between OPN and RAPN after propensity score matching, and it remained slightly lower for RAPN (250 vs. 300 ml, see Table ) 27 . Operating time and WIT were longer for RAPN, which is in line with other studies 23,28 . RAPN still had fewer postoperative complications than OPN ( p < 0.001), which has been published for (highly) complex lesions 29,30 .…”

The comparison of perioperative outcomes of robot-assisted and open partial nephrectomy: a systematic review and meta-analysis

“…2f ). The overall warm ischemia time of RAPN was significantly longer than that of OPN (WMD, 2.18 min; 95 % CI, 0.49 to 3.87; p = 0.01) as supported by the pooled data from 10 studies [ 6 , 8 , 9 , 11 , 12 , 19 , 20 , 23 , 24 ] (Fig. 2g ).…”

“…2c ) was found in the RAPN group. Eight studies [ 8 , 10 , 17 , 19 – 21 , 23 , 24 ] examined the perioperative transfusion, and we found that there was no significant difference in transfusion rate between RAPN and OPN (OR, 0.86; 95 % CI, 0.56 to 1.32; p = 0.50) (Fig. 2d ).…”

“…Thus, in total, there were 18 independent study populations included in this meta-analysis. Of the 16 studies, 4 studies conducted the comparison of perioperative outcomes of RAPN, LPN, and OPN [ 6 , 7 , 18 , 21 ], 12 studies documented their single center’s experience with RAPN versus OPN [ 6 – 10 , 12 , 16 , 18 , 19 , 21 – 23 ], 3 studies [ 11 , 17 , 20 ] involved the multicenter collaboration, and 10 studies [ 6 , 7 , 11 , 12 , 17 – 20 , 22 , 23 ] matched the two approach with renal tumor nephrometry score (RENAL or PADUA). Among the included studies, there was 2 prospective nonrandomized comparative study (level of evidence: II) [ 8 , 11 ], 3 studies retrospective analysis but prospective data collecting (level of evidence: III) [ 6 , 12 , 16 ], 9 retrospective studies compared contemporary of patients (level of evidence: III) [ 7 , 10 , 17 – 23 ], 1 retrospective study used a historical series as the control (level of evidence: IV) [ 9 ], and 1 retrospective study but a conference abstract (level of evidence: IV) [ 24 ].…”

Comparison of Renal Function between Robot-Assisted and Open Partial Nephrectomy as Determined by Tc 99m-DTPA Renal Scintigraphy

“…RAPN has now begun to be an alternative option to OPN because robot can offer a three-dimensional view of the operating field and fully flexible wristed-instrument motion, and overcome the learning curve for LPN ( 14 ). Several previous studies have compared RAPN with OPN and support the trend of increased use of RAPN ( 15 16 17 18 ).…”