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. 2019 Oct 4:12:8189-8196.
doi: 10.2147/OTT.S214060. eCollection 2019.

Role Of Robot-Assisted Partial Nephrectomy For Renal Cell Carcinomas In The Purpose Of Nephron Sparing

I-Hung Shao  1   2 , Hung-Cheng Kan  1   2 , Chung-Yi Liu  1   2 , Po-Hung Lin  1   2 , Kai-Jie Yu  1   2 , See-Tong Pang  1   2 , Chun-Te Wu  3 , Cheng-Keng Chuang  1   2 , Ying-Hsu Chang  1   2
Affiliations

Role Of Robot-Assisted Partial Nephrectomy For Renal Cell Carcinomas In The Purpose Of Nephron Sparing

I-Hung Shao et al. Onco Targets Ther. .

Erratum in

Abstract

Introduction: Surgery remains the standard treatment for localized renal cell carcinomas, and partial nephrectomy is considered before radical nephrectomy with the aim of preserving renal function. This study aimed to compare robot-assisted and open partial nephrectomy for the purpose of nephron sparing.

Materials and methods: We retrospectively enrolled consecutive patients who received partial nephrectomy at a single tertiary medical center from January 2008 to January 2015. Medical records and radiographic images were reviewed. We analyzed the patients' general characteristics, underlying disease, complications, length of hospital stay, renal tumor complexity, surgery type, renal function, and specimen and tumor size. A comparison between open and robot-assisted nephrectomy groups was performed.

Results: A total of 136 patients were enrolled, with a male to female ratio of 2:3 and a mean age of 57.8 years. Of these, 71 and 65 patients received open and robot-assisted surgery, respectively. Compared with the open group, patients who underwent robot-assisted surgery were significantly younger (56.0 versus 60.1 years old), had a longer operative time (303 versus 224 min), and a lower kidney ischemic time (33.4 versus 46.9 min). Given similar tumor sizes, the tumor-to-excision ratio was significantly higher in the robot-assisted group (51.7% versus 39.8%), and the excisional volume loss (EVL) was smaller (12.7 versus 19.6 mL). Preoperative glomerular filtration rate and EVL were significant predictors of long-term renal function preservation in the multivariate analysis.

Conclusion: When performing partial nephrectomy, a robot-assisted procedure could increase the accuracy of excision without increasing the risk of positive surgical margin. Lower EVL could assist in better long-term postoperative renal function preservation.

Keywords: excisional volume loss; nephron sparing; partial nephrectomy; renal cell carcinoma; renal function preservation; robotic-assisted system.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Illustration of actual tumor volume, excisional volume, and resection ratio.
Figure 2
Figure 2
Photograph of specimen to illustrate the measurement of length.
Figure 3
Figure 3
(A-B) The trend of GFR and GFR-P before and after partial nephrectomy in all patients. (C-D) The trend of GFR and GFR-P in patients with an EVL of ≥16 mL or <16 mL.
See this image and copyright information in PMC

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