Perioperative, oncologic, and functional outcomes of robot-assisted partial nephrectomy for special types of renal tumors (hilar, endophytic, or cystic): an evidence-based analysis of comparative outcomes

Chen, Xiaobin; Li, Yu-gen; Wu, Tao; Du, Zhongbo; Tan, Chen; Zhang, Qiang; Yu, Xiang

doi:10.3389/fonc.2023.1178592

Cited by 5 publications

(1 citation statement)

References 48 publications

(90 reference statements)

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“…This proximity makes it particularly important to repair these structures with traditional suturing techniques after damage during surgery, which is di cult to achieve with generally less invasive sutureless techniques. Studies have shown that partial nephrectomy for large or endophytic tumors involves longer operative times and a higher risk of surgical complications compared to radical nephrectomy [22][23][24].…”

Section: Discussionmentioning

confidence: 99%

From Sutureless to Standard: A Comprehensive Analysis of Conversion Rates in Laparoscopic Partial Nephrectomy

Li,

Hua,

Song

et al. 2024

Preprint

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Objective To assess the rate at which sutureless partial nephrectomy (SLPN) transitions to standard partial nephrectomy (SPN), focusing on preoperative factors that might prompt such conversions. Patients and methods In this retrospective study, we analyzed the efficacy of SLPN performed on adults at our institution from 2016 to 2023. The subjects were patients diagnosed with localized solid renal tumors. The primary technique employed was wedge resection, complemented by intraoperative ultrasound localization and argon beam coagulation for hemostasis, with suturing techniques used only when necessary. Predictive factors necessitating conversion to SPN were identified, and the associations among multiple variables were explored using various statistical analysis methods, including logistic regression, to identify key preoperative predictive factors. Results Our institution performed 353 SLPN, with 21 cases (5.9%) necessitating conversion to SPN. The conversion rates for the Laparoscopic Partial Nephrectomy (LPN) subgroup and the Robotic-assist Partial Nephrectomy (RPN) subgroup were 7.9% (17/215) and 2.9% (4/138), respectively, nearing statistical significance (P = .066). Significant differences were observed between the conversion group and the no conversion group in terms of preoperative estimated Glomerular Filtration Rate (eGFR), age at surgery, tumor size, and exophytic/endophytic characteristics. Multivariate analysis identified age at surgery, preoperative eGFR, radiological tumor size, and tumor exophytic/endophytic nature as significant predictors for conversion to SPN. Conclusion This investigation highlights the efficacy and feasibility of SLPN while identifying critical factors influencing the necessity for conversion to SPN. The identified predictors, including younger surgical age, superior preoperative eGFR, and specific tumor characteristics, provide valuable insights for refining surgical strategies.

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Section: Discussionmentioning

confidence: 99%