Agnes J Wang1, Sam B Bhayani. 1. Division of Urology, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
Abstract
OBJECTIVES: To compare a single-surgeon experience of laparoscopic partial nephrectomy (LPN) and robotic-assisted partial nephrectomy (RPN) in 102 consecutive patients. METHODS: The clinical, pathologic, and follow-up information from 102 consecutive procedures (40 RPNs and 62 LPNs) was reviewed. RESULTS: No statistically significant differences were found between the groups with regard to age, body mass index, or American Society of Anesthesiologists score. No significant difference was found between the estimated blood loss (136 vs 173 mL), tumor size (2.5 vs 2.4 cm), need for pelvicaliceal repair (56% for both), and positive margin rate (1 vs 1 patient) between RPN and LPN, respectively. The mean total number of trocars in the robotic group was greater than the laparoscopic group (4.6 vs 3.2, P = .01). The mean total operative time (140 vs 156 minutes, P = .04), warm ischemia time (19 vs 25 minutes, P = .03), and length of stay (2.5 vs 2.9 days, P = .03) were significantly shorter for RPN than for LPN, respectively. CONCLUSIONS: RPN can produce results comparable to LPN but has disadvantages, such as cost and assistant control of the renal hilum. Additional randomized trials are needed.
OBJECTIVES: To compare a single-surgeon experience of laparoscopic partial nephrectomy (LPN) and robotic-assisted partial nephrectomy (RPN) in 102 consecutive patients. METHODS: The clinical, pathologic, and follow-up information from 102 consecutive procedures (40 RPNs and 62 LPNs) was reviewed. RESULTS: No statistically significant differences were found between the groups with regard to age, body mass index, or American Society of Anesthesiologists score. No significant difference was found between the estimated blood loss (136 vs 173 mL), tumor size (2.5 vs 2.4 cm), need for pelvicaliceal repair (56% for both), and positive margin rate (1 vs 1 patient) between RPN and LPN, respectively. The mean total number of trocars in the robotic group was greater than the laparoscopic group (4.6 vs 3.2, P = .01). The mean total operative time (140 vs 156 minutes, P = .04), warm ischemia time (19 vs 25 minutes, P = .03), and length of stay (2.5 vs 2.9 days, P = .03) were significantly shorter for RPN than for LPN, respectively. CONCLUSIONS:RPN can produce results comparable to LPN but has disadvantages, such as cost and assistant control of the renal hilum. Additional randomized trials are needed.
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