Robot-Assisted Partial Nephrectomy Versus Laparoscopic Partial Nephrectomy: Comparison of Outcomes

Kural, Ali Rıza; Atug, Fatih; Tüfek, İlter; Akpınar, Haluk

doi:10.1089/end.2009.0377

Cited by 91 publications

(63 citation statements)

References 33 publications

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“…Our findings with respect to operative times (195 mins), and amounts of bleeding (and 250 mL) were generally in line with the findings in the medical literature. [1,11,18,19] We believe that our patients did not require blood transfusion because of effective and easy closure of the ports with the suture advantages of RAPN. Generalized subcutaneous ecchymosis that was observed in three of our patients in the postoperative period originated from the nearly lateral ports.…”

Section: Discussionmentioning

confidence: 85%

“…In the same study, the authors also reported that the mean duration of operation was 185 (120-170) minutes and the amount of bleeding was 286 ml for RAPN. [19] In general, it is observed that RAPN is more advantageous compared to LPN with respect to warm ischemia time. Warm ischemia time is important for reserving renal functions and Mir et al [3] reported that the preoperative renal functions and parenchymal volume preservation are important for ultimate function after PN.…”

Section: Discussionmentioning

confidence: 99%

“…The complications were grade 3 and 4 in 3.2% of the cases respectively. Kural et al [19] 3 Özkan et al Robotic-assisted partial nephrectomy without using ureteral stent: a single center experience . In the same study, the authors also reported that the mean duration of operation was 185 (120-170) minutes and the amount of bleeding was 286 ml for RAPN.…”

Section: Discussionmentioning

confidence: 99%

“…[20] In our study warm ischemia time which was the most significant predictive factor in PN was around 20 minutes in accordance with the medical literature (≤25 mins). [3,5,10,14,19] Lack of any significant difference between the pre-and postoperative serum creatinine levels of our patients can be evaluated as an indicator of the appropriateness of the procedure we performed in terms of warm ischemia times. Again, the mean surgical margin distance of 0.4 mm (0.2-1 cm) detected among our patients who had RCC can be considered a safe distance oncologically.…”

Section: Discussionmentioning

confidence: 99%

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Robotic-assisted partial nephrectomy without using ureteral stent: a single center experience

Özkan

Coşkuner

Yalçın

2016

Turkish Journal of Urology

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Objective: To share our results of robotic assisted partial nephrectomy (RAPN) we performed without using ureteral stent in a single center from Turkey. Material and methods:Medical records of consecutive 45 patients (34 men and 11 women) who underwent RAPN for kidney lesions between March 2011 and December 2014 were retrieved, and evaluated. All the procedures were performed by a transperitoneal approach without using ureteral stent prior to surgery. Renal artery clamping was used in all cases and intraoperative ultrasonography was used in 2 cases. Results:Patients undergoing RAPN had a mean tumor size of 4.42 cm (2-8) and a mean renal nephrometry score of 5.82 (4-11). The mean estimated blood loss was 250 mL (150-450 ml) and the mean operative time was 195 minutes (150-300). There was no statistical difference between the preoperative and postoperative serum creatinine levels at the first follow-up visit (0.9 vs. 0.95, p= 0.087). Surgical margin positivity was not detected in any patient, and the mean surgical margin distance was calculated as 0.4 mm (0.2-10). In only 1 patient disease recurrence was detected at the 21 st month of the the follow-up period, and no distant metastases was reported in our patients at a mean follow-up of 10 months (3-36 mos). Our complication rate was 11.1% and according to the Clavien system complications were as; grade 2 (3 patients), grade 3a (1 patient) and grade 3b (1 patient). Conclusion:With appropriately selected patients and adequate surgical experience, RAPN performed without using ureteral stent is a safe and feasible method for localized renal tumors.

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Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Robotic-assisted partial nephrectomy without using ureteral stent: a single center experience

Özkan

Coşkuner

Yalçın

2016

Turkish Journal of Urology

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“…[2] Minimally invasive surgery is increasingly being applied in the management of adrenal and renal masses, including laparoscopic [3][4][5][6][7] and robot-assisted laparoscopic approaches. [8][9][10][11][12][13][14][15] Here we present a challenging case of synchronously detected right adrenal and left renal masses resected via sequential robotic right adrenalectomy and zero ischemia off-clamp left partial nephrectomy.…”

Section: Introductionmentioning

confidence: 99%

Robotic sequential right adrenalectomy and zero ischemia left partial nephrectomy in a patient with synchronous pheochromocytoma and renal cell carcinoma

Canda

Cakici

Ener

et al. 2015

Turkish Journal of Urology

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Currently, most renal masses are detected incidentally while still small in size because of the widespread use of radiological imaging, and most pheochromocytomas are localized in the adrenal glands as unilateral lesions. A 5 x 4-cm right adrenal mass and a 19 x 13-mm exophytic left renal mass were synchronously detected by contrast enhancement on computed tomography and magnetic resonance imaging in a 47-yearold male with hypertension. The patient's preoperative serum and 24-h urine catecholamine levels were elevated. Initially, robotic transperitoneal right adrenalectomy was performed, and histopathology confirmed a 4 cm pheochromocytoma. After 3 months, transperitoneal zero ischemia robotic left partial nephrectomy was performed, and histopathology demonstrated clear cell renal cell carcinoma, Fuhrman grade II, 17 mm in size with clear surgical margins. This case indicates that sequential robotic surgery is feasible and safe as a minimally invasive approach to remove bilateral renal and adrenal masses. Zero ischemia robotic partial nephrectomy is also feasible and safe for selected small renal masses.

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Robot‐assisted versus laparoscopic partial nephrectomy for anatomically complex T1b renal tumors with a RENAL nephrometry score ≥7: A propensity score‐based analysis

Deng

Liu

et al. 2019

Cancer Medicine

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Objectives:To present the perioperative, functional, and oncological outcomes of robot-assisted partial nephrectomy (RPN) compared with laparoscopic partial nephrectomy (LPN) for anatomically complex T1b renal tumors with RENAL nephrometry scores ≥7. Patients and methods: One hundred and seventy patients, during the study period, were retrospectively reviewed in our analysis according to inclusion criteria.Propensity score matching (PSM) (1:1) method was applied to impose restrictions on the potential baseline confounders. The comparisons of perioperative and functional outcomes between the RPN and LPN groups were conducted and analyzed after PSM, Kaplan-Meier analyses were performed to assess the differences about oncological outcomes between the two groups before and after PSM. Results: One hundred and nine and 61 T1b renal tumors with RENAL scores ≥7 were identified in the LPN and RPN groups, respectively. All significant differences in baseline characteristics disappeared after PSM. Except for 3 patients missing an appropriate pair, all the patients in the RPN group were successfully matched to 58 patients in the LPN group in a 1:1 ratio. Within the matched cohort, the RPN group was related to a significantly shorter mean operating time (OT) (P = .040), shorter mean warm ischemia time (WIT) (P = .023), and shorter median postoperative hospital stay (P = .023). The possibilities of surgical conversion, postoperative complication, and positive surgical margin were similar in the LPN and RPN groups.And there was also no significant difference in the pathological, renal functional, and oncological outcomes between the two series. Conclusions: For patients with anatomically complex T1b renal tumors with a RENAL nephrometry score ≥7, RPN had an advantage over LPN in reducing OT, WIT, and postoperative hospital stay length without increasing the risk of | 587 DENG Et al.

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Robot-Assisted Partial Nephrectomy Versus Laparoscopic Partial Nephrectomy: Comparison of Outcomes

Cited by 91 publications

References 33 publications

Robotic-assisted partial nephrectomy without using ureteral stent: a single center experience

Robotic-assisted partial nephrectomy without using ureteral stent: a single center experience

Robotic sequential right adrenalectomy and zero ischemia left partial nephrectomy in a patient with synchronous pheochromocytoma and renal cell carcinoma

Robot‐assisted versus laparoscopic partial nephrectomy for anatomically complex T1b renal tumors with a RENAL nephrometry score ≥7: A propensity score‐based analysis

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