The Influence of Prior Abdominal Surgery on Robot-Assisted Partial Nephrectomy

Abstract

Background: The aim of this study was to evaluate the influence of prior abdominal surgery on perioperative outcomes in patients who underwent robot-assisted partial nephrectomy.Methods: We reviewed patients with small renal tumors who underwent robot-assisted partial nephrectomy from October 2011 to September 2020 at our institution. Comparisons between patients with prior abdominal surgery and with no prior abdominal surgery were based on perioperative outcomes. Furthermore, patients underwent transperitoneal robot-assisted partial nephrectomy was compared between those with and without prior abdominal surgery. The Mann–Whitney U test and the chi-square test were used for statistical analyses of variables. Results: Of 156 patients who underwent robot-assisted partial nephrectomy, 90 (58 %) had no prior abdominal surgery, whereas 66 patients (42 %) underwent prior abdominal surgery. No significant differences in perioperative outcomes were observed between with and without prior abdominal surgery groups. In transperitoneal approach robot-assisted partial nephrectomy, 31 patients (38.8 %) had prior abdominal surgery, whereas 49 patients had no prior abdominal surgery. Trocar insertion time in the with prior abdominal surgery group took longer than the without prior abdominal surgery group (32 vs. 28.5 min, p = 0.031). The other perioperative outcomes were no significant differences. In the conversion rate, no significant difference was observed between the two groups (p = 0.556).Conclusions: Prior abdominal surgery does not appear to affect Robot-assisted partial nephrectomy. Robot-assisted partial nephrectomy can be a safe procedure for patients with prior abdominal surgery. In transperitoneal approach robot-assisted partial nephrectomy with prior abdominal surgery, trocar insertion time was longer, but no significant differences were found in other outcomes. The conversions to radical nephrectomy and open partial nephrectomy were not associated with prior abdominal surgery. Transperitoneal approach robot-assisted partial nephrectomy is thus considered a safe procedure for patients with prior abdominal surgery.