Please use this identifier to cite or link to this item: http://hdl.handle.net/11434/1255
Title: Comparison of perioperative, renal and oncologic outcomes in robotic-assisted versus open partial nephrectomy.
Epworth Authors: Grummet, Jeremy
Snow, Ross
Moon, Daniel
Frydenberg, Mark
Other Authors: Tan, Jo-Lynn
Hanegbi, Uri
Mann, Sarah
Begashaw, Kirobel
Keywords: Complications
Kidney
Partial Nephrectomy
Renal Tumour
Robotic Surgery
Robotic-Assisted Partial Nephrectomy
RAPN
Open Partial Nephrectomy
OPN
Oncology
Cancer
Cancer Services Clinical Institute, Epworth Healthcare, Victoria, Australia
UroRenal and Vascular Services Clinical Institute, Epworth Healthcare, Victoria, Australia.
Issue Date: Sep-2017
Publisher: Wiley
Citation: ANZ J Surg. 2017 Sep 18.
Abstract: BACKGROUND: To compare perioperative, renal and oncological outcomes after robotic-assisted partial nephrectomy (RAPN) versus open partial nephrectomy (OPN) for the treatment of renal tumours. METHODS: All partial nephrectomies performed at a Metropolitan Urology Centre between 2010 and 2016 were analysed. Baseline data was collected for patient demographics, tumour characteristics (tumour size, laterality and polarity, RENAL scores), and perioperative variables (e.g. warm ischaemic time, operation time, estimated blood loss (EBL), length of stay). Tumour characteristics included malignancy, clinical stage, Fuhrman nuclear grade and surgical margin status. Day-1 post-operative serum creatinine, estimated glomerular filtration rate (eGFR) and 6-month eGFR stage were used for assessing renal function. RESULTS: Two hundred patients underwent partial nephrectomy between 2010 and 2016 (n = 200; 55 OPN versus 145 RAPN). Baseline data was similar between groups, except for lower age (P = 0.0001) and higher RENAL scores (P = 0.001) in the RAPN group. RAPN demonstrated significantly lower complication rates (P = 0.015), lesser EBL (P = <0.0001), shorter hospital stays (P = <0.001) and reduced positive tumour resection margins (P = 0.039). There was no significant difference in mean operation time between RAPN and OPN (137.2 (±48.0) OPN versus 146.07 (±35.91) RAPN; P = 0.16). No statistical difference was shown for post-operative eGFR stage between groups at Day-1 and 6-month post-surgery (P = 0.15 and P = 0.861, respectively). CONCLUSION: We present the largest reported Australian series on partial nephrectomy, confirming that a robotic-assisted approach is equivalent to OPN, with reduced complications, EBL, length of hospital stays and fewer positive margins, even when resecting more complex tumours.
URI: http://hdl.handle.net/11434/1255
DOI: 10.1111/ans.14154
PubMed URL: https://www.ncbi.nlm.nih.gov/pubmed/28922687
ISSN: 1445-2197
Journal Title: ANZ Journal of Surgery
Type: Journal Article
Affiliated Organisations: School of Medicine, The University of Western Australia, Perth, Western Australia, Australia.
Department of Urology, Cabrini Healthcare, Melbourne, Victoria, Australia.
Australian Urology Associates, Melbourne, Victoria, Australia.
Department of Surgery, Central Clinical School, Monash University, Melbourne, Victoria, Australia.
Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
Type of Clinical Study or Trial: Retrospective studies
Appears in Collections:Cancer Services
UroRenal, Vascular

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