Postoperative renal function in patients is unaltered after robotic-assisted radical prostatectomy

Area of Science:

• Nephrology
• Urology
• Surgical Oncology

Background:

• Elevated intra-abdominal pressure (IAP) during pneumoperitoneum can impair renal function.
• Robotic-assisted radical prostatectomy (RARP) necessitates an IAP exceeding 15 mmHg.

Purpose of the Study:

• To investigate the impact of RARP on renal function in the postoperative period.
• To determine if RARP induces renal insufficiency at 7 and 30 days post-surgery.

Main Methods:

• Retrospective analysis of 100 patients undergoing RARP.
• Measurement of serum BUN, creatinine, and calculated creatinine clearance (CrCl) at various postoperative time points.
• Group assignment based on preoperative CrCl levels (normal vs. abnormal).

Main Results:

• BUN and creatinine levels decreased significantly in the early postoperative period (2 hr to POD 7) compared to baseline in both groups.
• Creatinine clearance (CrCl) increased significantly in the early postoperative period (2 hr to POD 7) compared to baseline in both groups.
• Renal function markers (BUN, Cr, CrCl) returned to preoperative levels by postoperative day 30.

Conclusions:

• RARP, even with IAP of 15-20 mmHg for over 4 hours, does not lead to sustained renal dysfunction postoperatively.
• Patients with pre-existing abnormal CrCl did not experience worsened renal insufficiency after RARP.
• RARP is a safe procedure regarding short-term and mid-term renal function outcomes.