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Early experience and operative technique of robotic‐assisted partial nephrectomy
Author(s) -
Kucharczyk John R.,
Basto Marnique,
Landau Adam,
Graves Reid,
Everaerts Wouter,
Birch Emma,
Murphy Declan,
Moon Daniel
Publication year - 2014
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.12649
Subject(s) - medicine , nephrectomy , perioperative , renal function , surgery , blood loss , kidney disease , body mass index , dialysis , pathological , urology , kidney
Background The adoption of robotic‐assisted partial nephrectomy ( RAPN ) is increasing in A ustralia; however, to date no A ustralian RAPN series has been reported. This paper describes a single‐surgeon initial experience with RAPN and evaluates perioperative, pathological and oncological outcomes. Methods Data on the first 50 consecutive patients to undergo RAPN by a single surgeon were reviewed. Demographic, perioperative, tumour characteristics and C lavien complications were collected in addition to oncological follow‐up and renal function monitoring. Results Mean age was 58.2 ± 10.4 years, body mass index was 28.8 ± 4.5 kg/m 2 and C harlson C o‐morbidity I ndex was 4.6 ± 1.2. Tumour diameter was 31 ± 13 mm and RENAL score was 6.8 ± 1.5. Average total operative time was 151 ± 32.7 min, estimated blood loss was 171.1 ± 185.8 mL, warm ischaemia time was 17.8 ± 6.7 min and length of hospital stay was 3 ± 0.9 days. There were seven C lavien complications and no deaths. Estimated glomerular filtration rate did not decrease significantly post‐operatively ( P = 0.8); and there was 14.6% upstaging of chronic kidney disease scoring although no patient required dialysis. There were no positive malignant surgical margins, and to date no patient has evidence of disease recurrence. Of 50 patients, 54% had a minimum follow‐up of 6 months and 28% had a minimum follow‐up of 1 year. Conclusion We report the largest RAPN study in A ustralia or N ew Z ealand to date. Initial results suggest that RAPN can be safely introduced into the A ustralian public and private health systems, and has been effective in oncologic control and renal function preservation.