The State of Robotic Partial Nephrectomy: Operative, Functional, and Oncological Outcomes From A Robust Multi-Institution Collaborative.

Authors

• Shirin Razdan
• Kennedy E Okhawere
• Burak Ucpinar
• Indu Saini
• Antony Deluxe
• Ronney Abaza
• Daniel D Eun
• Akshay Bhandari
• Ashok K Hemal
• James Porter
• Michael D Stifelman
• Simone Crivellaro
• Phillip M Pierorazio
• Ketan K Badani

Publication/Presentation Date

3-1-2023

Abstract

OBJECTIVE: To describe the most recent surgical, functional, and oncological outcomes of RPN utilizing one of the largest, prospectively maintained, multi-institution consortium of patients undergoing robotic renal surgery.

MATERIALS AND METHODS: Data was obtained from a prospectively maintained multi-institutional database of patients who underwent RPN for clinically localized kidney cancer between 2018 and 2022 by 9 high-volume surgeons. Demographic and tumor characteristics as well as operative, functional, and oncological outcomes were queried.

RESULTS: A total of 2836 patients underwent RPN. Intraoperative, postoperative, and 30-day major complication rates were 2.68%, 11.39%, and 3.24%, respectively. Median tumor size was 3.0 cm. Tumors with low complexity had a shorter median operative time, lower median EBL, shorter median ischemia time, lower postoperative complication rate, and lower decline in renal function There was no significant difference between tumor complexities with respect to the rate of conversion to radical nephrectomy, conversion to open, major complications, and positive margins. Lower BMI, smaller clinical tumor size, lower tumor complexity, and higher baseline eGFR were significantly associated with trifecta achievement.

CONCLUSION: Patient BMI, baseline eGFR, and tumor characteristics such as size and complexity are the most important predictors of trifecta achievement. Patients with complex tumors should be counseled that they are at increased risk of complications and worsening renal function after robotic partial nephrectomy.

Volume

173

First Page

92

Last Page

97

ISSN

1527-9995

Published In/Presented At

Razdan, S., Okhawere, K. E., Ucpinar, B., Saini, I., Deluxe, A., Abaza, R., Eun, D. D., Bhandari, A., Hemal, A. K., Porter, J., Stifelman, M. D., Crivellaro, S., Pierorazio, P. M., & Badani, K. K. (2023). The State of Robotic Partial Nephrectomy: Operative, Functional, and Oncological Outcomes From A Robust Multi-Institution Collaborative. Urology, 173, 92–97. https://doi.org/10.1016/j.urology.2022.12.021

Disciplines

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

PubMedID

36592701

Department(s)

Administration and Leadership

Document Type

Article