TY - JOUR
T1 - Robotic partial nephrectomy for management of renal mass in patients with a solitary kidney
T2 - can we expand the indication to T2 and T3 disease?
AU - Beksac, Alp T.
AU - Okhawere, Kennedy E.
AU - Abou Zeinab, Mahmoud
AU - Harrison, Bobby
AU - Stifelman, Michael D.
AU - Eun, Daniel D.
AU - Abaza, Ronney
AU - Badani, Ketan K.
AU - Kaouk, Jihad H.
N1 - Publisher Copyright:
© 2021 EDIZIONI MINERVA MEDICA.
PY - 2022/4
Y1 - 2022/4
N2 - BaCKgroUNd: Management of complex renal masses is challenging in a solitary kidney setting. We retrospectively compared oncological and renal functional outcomes between robotic and open partial nephrectomy (pN) in patients with a pT2-pT3 renal mass and a solitary kidney. METHODS: From a multi-institutional series, we identified 20 robotic partial nephrectomies (RPN) and 15 open partial nephrectomies (OPN) patients confirmed to have a pT2 or pT3 renal cancer. Surgeries were performed between January 2012 and July 2019. patients with familial renal cell carcinoma, prior ipsilateral pN, or multiple ipsilateral synchronous tumors were excluded from the analysis. Baseline characteristics, perioperative and postoperative outcomes were compared using χ2 test, Fisher’s exact Test, Mann-Whitney U Test, and Student’s t-test. reSUlTS: Baseline characteristics were comparable. Cold ischemia was utilized more in the open group (92.9% vs. 15.8%, p<0.001). opN group had a longer ischemia time (48.9 min vs. 27.3 min, p<0.001), a higher major complication rate (38.5% vs. 11.1%, p=0.009), and a higher length of stay was (5 vs. 3.5 days, p=0.023). positive surgical margin rate was comparable (20% opN vs. 15% rpN; p=1.000). at a mean follow up of 21 months local recurrence rates (1 opN vs. 2 rpN, p=1.000) were comparable, chronic kidney disease upstaging rate (46.7% opN vs. 45.0% rpN, p=0.922) and estimated glomerular filtration rate preservation at one year (75.2%% in OPN vs. 79.1% rpN, p=0.707) were comparable. CoNClUSioNS: in select cases and experienced hands, the robotic approach offers a reasonable alternative to open surgery in patients with pT2 and pT3 tumors and a solitary kidney. (Cite this article as: Beksac aT, okhawere Ke, abou Zeinab M, harrison B, Stifelman Md, eun dd, et al. robotic partial nephrectomy for management of renal mass in patients with a solitary kidney: can we expand the indication to T2 and T3 disease?.
AB - BaCKgroUNd: Management of complex renal masses is challenging in a solitary kidney setting. We retrospectively compared oncological and renal functional outcomes between robotic and open partial nephrectomy (pN) in patients with a pT2-pT3 renal mass and a solitary kidney. METHODS: From a multi-institutional series, we identified 20 robotic partial nephrectomies (RPN) and 15 open partial nephrectomies (OPN) patients confirmed to have a pT2 or pT3 renal cancer. Surgeries were performed between January 2012 and July 2019. patients with familial renal cell carcinoma, prior ipsilateral pN, or multiple ipsilateral synchronous tumors were excluded from the analysis. Baseline characteristics, perioperative and postoperative outcomes were compared using χ2 test, Fisher’s exact Test, Mann-Whitney U Test, and Student’s t-test. reSUlTS: Baseline characteristics were comparable. Cold ischemia was utilized more in the open group (92.9% vs. 15.8%, p<0.001). opN group had a longer ischemia time (48.9 min vs. 27.3 min, p<0.001), a higher major complication rate (38.5% vs. 11.1%, p=0.009), and a higher length of stay was (5 vs. 3.5 days, p=0.023). positive surgical margin rate was comparable (20% opN vs. 15% rpN; p=1.000). at a mean follow up of 21 months local recurrence rates (1 opN vs. 2 rpN, p=1.000) were comparable, chronic kidney disease upstaging rate (46.7% opN vs. 45.0% rpN, p=0.922) and estimated glomerular filtration rate preservation at one year (75.2%% in OPN vs. 79.1% rpN, p=0.707) were comparable. CoNClUSioNS: in select cases and experienced hands, the robotic approach offers a reasonable alternative to open surgery in patients with pT2 and pT3 tumors and a solitary kidney. (Cite this article as: Beksac aT, okhawere Ke, abou Zeinab M, harrison B, Stifelman Md, eun dd, et al. robotic partial nephrectomy for management of renal mass in patients with a solitary kidney: can we expand the indication to T2 and T3 disease?.
KW - Carcinoma, renal cell
KW - Kidney
KW - Nephrectomy
KW - Solitary kidney
UR - http://www.scopus.com/inward/record.url?scp=85128000349&partnerID=8YFLogxK
U2 - 10.23736/S2724-6051.22.04671-7
DO - 10.23736/S2724-6051.22.04671-7
M3 - Article
C2 - 35345388
AN - SCOPUS:85128000349
SN - 2724-6051
VL - 74
SP - 203
EP - 208
JO - Minerva Urology and Nephrology
JF - Minerva Urology and Nephrology
IS - 22
ER -