Robot-assisted partial nephrectomy for sporadic ipsilateral multifocal renal tumours

Area of Science:

• Urology
• Minimally Invasive Surgery
• Oncology

Background:

• Multiple ipsilateral renal tumors present a surgical challenge.
• Partial nephrectomy is the gold standard for preserving renal function.

Purpose of the Study:

• To evaluate the short-term outcomes of robot-assisted partial nephrectomy (RAPN) for sporadic multiple ipsilateral renal tumors.
• To assess the feasibility and safety of RAPN in this specific patient group.

Main Methods:

• Retrospective review of eight patients undergoing nine RAPNs for multiple ipsilateral renal masses over three years.
• Evaluation of PADUA and R.E.N.A.L. nephrometry scores, operative details, complications (Clavien classification), and renal function.
• Analysis of histopathological findings.

Main Results:

• Nineteen tumors were resected in nine procedures with no intraoperative complications or need for blood transfusion.
• Mean operative time was 200 minutes; mean tumor size was 2.2 cm.
• Mean warm ischemia time was 21 minutes (for off-clamp resections); mean decrease in glomerular filtration rate was 4% with 14-month follow-up.
• Most resected tumors (16/19) were malignant, predominantly papillary type, Fuhrman grade II.

Conclusions:

• Robot-assisted partial nephrectomy is a safe and feasible surgical option for managing sporadic ipsilateral multifocal renal tumors.
• Off-clamp resection of multiple renal tumors can be safely performed in select cases using robotic assistance.