Robot-assisted partial nephrectomy for complex renal tumors: Analysis of a large multi-institutional database.

Authors

• Burak Ucpinar
• Jordan Miller Rich
• Kennedy E Okhawere
• Shirin Razdan
• Osama Zaytoun
• Laura Zuluaga
• Indu Saini
• Michael D Stifelman
• Ronney Abaza
• Daniel D Eun
• Akshay Bhandari
• Ashok K Hemal
• James Porter
• Simone Crivellero
• Ahmed Mansour
• Phillip M Pierorazio
• Ketan K Badani

Publication/Presentation Date

8-1-2023

Abstract

INTRODUCTION: Highly complex renal masses pose a challenge to urologic surgeons' ability to perform robotic partial nephrectomy (RPN). Given the increased utilization of the robotic approach for small renal masses, we sought to characterize the outcomes and determine the safety and feasibility of RPN for complex renal masses from our large multi-institutional cohort.

METHODS: We performed a retrospective analysis of patients with R.E.N.A.L. Nephrometry Scores ≥10 who underwent RPN in our multi-institutional cohort (N = 372). Baseline demographic, clinical and tumor related characteristics were evaluated with the primary endpoint of trifecta achievement (defined as negative surgical margin, no major complications, and warm ischemia time ≤25 min). Relationships between variables were assessed using the chi-square test of independence, Fisher exact test, Mann-Whitney U test, and Kruskal Wallis test. Logistic regression was used to evaluate the relationship between baseline characteristics and trifecta achievement.

RESULTS: Of 372 patients in the study, mean age was 58 years, and median BMI was 30.49 kg/m

CONCLUSION: RPN is a safe and reproducible procedure for complex tumors with R.E.N.A.L. Nephrometry scores ≥10. Our results suggest excellent rates of trifecta achievement and short-term functional outcomes when performed by experienced surgeons. Long-term oncological and functional evaluation are needed to further support this conclusion.

Volume

41

Issue

8

First Page

9

Last Page

358

ISSN

1873-2496

Published In/Presented At

Ucpinar, B., Rich, J. M., Okhawere, K. E., Razdan, S., Zaytoun, O., Zuluaga, L., Saini, I., Stifelman, M. D., Abaza, R., Eun, D. D., Bhandari, A., Hemal, A. K., Porter, J., Crivellero, S., Mansour, A., Pierorazio, P. M., & Badani, K. K. (2023). Robot-assisted partial nephrectomy for complex renal tumors: Analysis of a large multi-institutional database. Urologic oncology, 41(8), 358.e9–358.e15. https://doi.org/10.1016/j.urolonc.2023.05.016

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

37316415

Department(s)

Administration and Leadership

Document Type

Article