Ygal Benichou1, François Audenet2, Karim Bensalah3, Morgan Roupret4, Philippe Paparel5, Cedric Lebacle6, Franck Bruyère7, Jean-Baptiste Beauval8, Arnauld Villers9, Hervé Lang10, Xavier Durand11, Pierre Bigot12, Jean Alexandre Long13, Cécile Champy14, Alexandre Lavolle15, Jean Christophe Bernhard16, Eric Alezra16. 1. Urology Department of Hôpital Européen Georges-Pompidou, 20 rue Leblanc, 75015, Paris, France. ygal.benichou@aphp.fr. 2. Urology Department of Hôpital Européen Georges-Pompidou, 20 rue Leblanc, 75015, Paris, France. 3. Urology Department of Rennes, Rennes, France. 4. Urology Department of La Pitié-Salpétrière, Paris, France. 5. Urology Department of Lyon, Lyon, France. 6. Urology Department of Le Kremlin-Bicètre, Le Kremlin Bicetre, France. 7. Urology Department of Tours, Tours, France. 8. Urology Department of La Croix Du Sud, Pierre-Bénite, France. 9. Urology Department of Lille, Paris, France. 10. Urology Department of Strasbourg, Strasbourg, France. 11. Urology Department of St. Joseph, Paris, France. 12. Urology Department of Angers, Angers Cedex 9, France. 13. Urology Department of Grenoble, Grenoble Cedex 9, France. 14. Urology Department of Henri-Mondor, Creteil, France. 15. Urology Department of Bichat, Paris, France. 16. Urology Department of Bordeaux, Bordeaux, France.
Abstract
PURPOSE: The management of solitary kidney tumors is a surgical challenge, requiring irreproachable results on both oncological and functional outcomes. The goal of our study was to compare the perioperative results of robotic-assisted partial nephrectomy (RAPN) to open surgery in this indication. METHODS: We led a multicentric study based on the prospectively maintained French national database UroCCR. Patients who underwent partial nephrectomy on a solitary kidney between 1988 and 2020 were included. Clinical and pathological data were retrospectively analyzed. The main outcome of the study was the analysis of the variation of the estimated glomerular filtration rate (eGFR) calculated according to MDRD at 3, 6, 12, and 24 months depending on the chosen surgical approach. The secondary outcomes were the comparison of Trifecta success, perioperative complications, and length of hospital stay. RESULTS: In total, 150 patients were included; 68 (45%) in the RAPN group and 82 (55%) in the open surgery group. The two groups were comparable for all data. The variation of eGFR at 3, 6, 12, or 24 months was comparable without any significant difference between the 2 groups (p = 0.45). Trifecta was achieved in 40% of the patients in the RAPN group and 33% in the open group (p = 0.42). A significant difference was observed for the length of stay, 5 days for the robot group versus 9 days for the open surgery group (p < 0.0001). CONCLUSION: In our study, the surgical approach did not modify functional results and we noted a significant decrease in hospital stay and complications in the RAPN group. RAPN is a safe and efficient method for management of kidney tumors in solitary kidneys.
PURPOSE: The management of solitary kidney tumors is a surgical challenge, requiring irreproachable results on both oncological and functional outcomes. The goal of our study was to compare the perioperative results of robotic-assisted partial nephrectomy (RAPN) to open surgery in this indication. METHODS: We led a multicentric study based on the prospectively maintained French national database UroCCR. Patients who underwent partial nephrectomy on a solitary kidney between 1988 and 2020 were included. Clinical and pathological data were retrospectively analyzed. The main outcome of the study was the analysis of the variation of the estimated glomerular filtration rate (eGFR) calculated according to MDRD at 3, 6, 12, and 24 months depending on the chosen surgical approach. The secondary outcomes were the comparison of Trifecta success, perioperative complications, and length of hospital stay. RESULTS: In total, 150 patients were included; 68 (45%) in the RAPN group and 82 (55%) in the open surgery group. The two groups were comparable for all data. The variation of eGFR at 3, 6, 12, or 24 months was comparable without any significant difference between the 2 groups (p = 0.45). Trifecta was achieved in 40% of the patients in the RAPN group and 33% in the open group (p = 0.42). A significant difference was observed for the length of stay, 5 days for the robot group versus 9 days for the open surgery group (p < 0.0001). CONCLUSION: In our study, the surgical approach did not modify functional results and we noted a significant decrease in hospital stay and complications in the RAPN group. RAPN is a safe and efficient method for management of kidney tumors in solitary kidneys.
Authors: Nicolò Maria Buffi; Alberto Saita; Giovanni Lughezzani; James Porter; Paolo Dell'Oglio; Daniele Amparore; Cristian Fiori; Geert Denaeyer; Francesco Porpiglia; Alex Mottrie Journal: Eur Urol Date: 2019-03-19 Impact factor: 20.096
Authors: Simon P Kim; Steven C Campbell; Inderbir Gill; Brian R Lane; Hein Van Poppel; Marc C Smaldone; Alessandro Volpe; Alexander Kutikov Journal: Eur Urol Date: 2016-12-14 Impact factor: 20.096
Authors: K Bensalah; L Albiges; J-C Bernhard; P Bigot; T Bodin; R Boissier; J-M Correas; P Gimel; J-F Hetet; J-A Long; F-X Nouhaud; I Ouzaïd; N Rioux-Leclercq; A Méjean Journal: Prog Urol Date: 2018-10-26 Impact factor: 0.915
Authors: Ercan Malkoc; Daniel Ramirez; Onder Kara; Matthew J Maurice; Ryan J Nelson; Peter A Caputo; Jihad H Kaouk Journal: World J Urol Date: 2016-09-23 Impact factor: 4.226