Strategies for success: a multi-institutional study on robot-assisted partial nephrectomy for complex renal lesions
AuthorHennessey, DB; Wei, G; Moon, D; Kinnear, N; Bolton, DM; Lawrentschuk, N; Chan, YK
Source TitleBJU International
AffiliationSurgery (Austin & Northern Health)
Document TypeJournal Article
CitationsHennessey, D. B., Wei, G., Moon, D., Kinnear, N., Bolton, D. M., Lawrentschuk, N. & Chan, Y. K. (2018). Strategies for success: a multi-institutional study on robot-assisted partial nephrectomy for complex renal lesions. BJU INTERNATIONAL, 121, pp.40-47. https://doi.org/10.1111/bju.14059.
Access StatusOpen Access
OBJECTIVE: To describe our technique, illustrated with images and videos, of robot-assisted partial nephrectomy (RAPN) for challenging renal tumours. PATIENTS AND METHODS: A study of 249 patients who underwent RAPN in multiple institutions was performed. Patients were identified using prospective RAPN databases. Complex renal lesion were defined as those with a RENAL nephrometry score ≥10. Data were analysed and differences among groups examined. RESULTS: A total of 31 (12.4%) RAPNs were performed for complex renal tumours. The median (interquartile range [IQR]) patient age was 57 (50.5-70.5) years and 21 patients (67.7%) were men. The median (IQR) American Society of Anesthesiologists score was 2 (2-3). The median (IQR) operating time was 200 (50-265) min, warm ischaemia time was 23 (18.5-29) min, and estimated blood loss was 200 (50-265) mL. There were no intra-operative complications. Two patients (6.4%) had postoperative complications. One patient (3.2%) had a positive surgical margin. The median (IQR) length of stay was 3.5 (3-5) days and the median (IQR) follow-up was 12.5 (7-24) months. There were no recurrences. RAPN resulted in statistically significant changes in renal function 3 months after RAPN compared with preoperative renal function (P < 0.001). CONCLUSION: Our results showed that RAPN was a safe approach for selected patients with complex renal tumours and may facilitate tumour resection and renorrhaphy for challenging cases, offering a minimally invasive surgical option for patients who may otherwise require open surgery.
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