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Robotic and open partial nephrectomy for localized renal tumors larger than 7 cm: a single-center experience

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Abstract

Purpose

To compare perioperative outcomes between robotic partial nephrectomy and open partial nephrectomy for localized >7 cm tumors.

Methods

We identified patients in our institutional review boards approved database who underwent robotic partial nephrectomy or open partial nephrectomy for treatment of renal tumors >7 cm in size between January 2009 and August 2015. The operative–postoperative outcomes and complications were compared between groups.

Results

The number of patients with >7 cm renal tumors treated at our center with robotic partial nephrectomy and open partial nephrectomy were 54 and 56, respectively. Patients’ demographics and tumor characteristics were similar between groups. Likewise, there were no significant difference between the groups in duration of operation, positive surgical margin rates and incidence of malignant disease rates. Median ischemia time was lower in robotic partial nephrectomy group (31.5 vs. 35 min., p = 0.02). Patients undergoing robotic partial nephrectomy had significantly lower intraoperative blood transfusion rates (9.4 vs. 30.4 %, p = 0.008) and shorter length of hospital stay (3.5 vs. 5.3 days, p < 0.001). The incidence of overall complications (robotic arm, 18.5 % vs. open arm, 28.6 %, p = 0.26) and major complications (robotic arm, 3.7 % vs. open arm, 12.5 %, p = 0.16) was comparable between the two groups. The readmission rate within 30-days after discharge was higher in open partial nephrectomy group (p = 0.03). There was no difference in the median percentage estimated glomerular filtration rate preservation and chronic kidney disease upstaging between groups.

Conclusions

Localized renal tumors >7 cm and amenable to partial nephrectomy can be considered suitable for robotic approach.

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Authors’ contribution

E Malkoc was involved in project development, manuscript writing, data management and data collection. D. Ramirez was involved in project development, data collection and manuscript editing. O. Kara was involved in data analysis, data collection and manuscript editing. MJ. Maurice was involved in data collection. RJ. Nelson was involved in data collection. PA. Caputo was involved in data collection. J. Kaouk was involved in project development, data management and manuscript editing.

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Authors and Affiliations

  1. Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, 9500 Euclid Ave., Q10-1, Cleveland, OH, 44195, USA

    Ercan Malkoc, Daniel Ramirez, Onder Kara, Matthew J. Maurice, Ryan J. Nelson, Peter A. Caputo & Jihad H. Kaouk

  2. Urology Department, University of Health Science, Sultan Abdulhamid Education and Training Hospital, Istanbul, Turkey

    Ercan Malkoc

  3. Urology Department, Amasya University Medical School, Amasya, Turkey

    Onder Kara

Authors
  1. Ercan Malkoc
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  2. Daniel Ramirez
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  3. Onder Kara
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  4. Matthew J. Maurice
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  6. Peter A. Caputo
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  7. Jihad H. Kaouk
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Corresponding author

Correspondence to Jihad H. Kaouk.

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Conflicts of interest

Jihad H. Kaouk is a consultant for Endocare. No competing financial interests exist for the other authors.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study had previously.

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Malkoc, E., Ramirez, D., Kara, O. et al. Robotic and open partial nephrectomy for localized renal tumors larger than 7 cm: a single-center experience. World J Urol 35, 781–787 (2017). https://doi.org/10.1007/s00345-016-1937-9

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  • DOI: https://doi.org/10.1007/s00345-016-1937-9

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