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Comparison of robot‐assisted and laparoscopic partial nephrectomy for complex renal tumours with a RENAL nephrometry score ≥7: peri‐operative and oncological outcomes
Author(s) -
Wang Yubin,
Ma Xin,
Huang Qingbo,
Du Qingshan,
Gong Huijie,
Shang Jiwen,
Zhang Xu
Publication year - 2016
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.13214
Subject(s) - medicine , nephrectomy , blood loss , perioperative , renal function , surgery , urology , laparoscopy , renal cell carcinoma , kidney
Objective To evaluate the peri‐operative, functional and oncological outcomes of robot‐assisted partial nephrectomy (RAPN) and laparoscopic partial nephrectomy (LPN) for moderately or highly complex tumours (defined as RENAL nephrometry score ≥7). Patients and Methods We retrospectively analysed the medical charts of 216 patients with complex tumours who underwent LPN ( n = 135) or RAPN ( n = 81) between 2008 and 2014. Peri‐operative data, pathological variables, complications, functional and oncological outcomes were reviewed. Results Demographic characteristics were similar in the two groups. LPN was associated with a longer operating time (149.6 vs 135.6 min; P = 0.017) and greater estimated blood loss (220.8 vs 196.5 mL; P = 0.013). RAPN was associated with a higher direct cost. There were no differences in warm ischaemia time, transfusion rate, conversion rate, hospital stay, operative complications and estimated glomerular filtration rate change at 6 months after surgery. The mean follow‐ups for LPN and RAPN were 31.4 and 16.5 months, respectively. The 3‐year recurrence‐free survival rate was 95.2% for LPN and 97.1% for RAPN ( P = 0.71). Conclusion In patients with complex tumours, RAPN and LPN provided acceptable and similar results in terms of peri‐operative, functional and oncological outcomes. RAPN was superior to LPN in terms of estimated blood loss and operating time, and LPN was the more cost‐effective approach. Both surgery techniques remain viable options in the management of complex tumours with RENAL scores ≥7.