A multicentre matched-pair analysis comparing robot-assisted versus open partial nephrectomy.

Area of Science:

• Urology
• Surgical Oncology
• Nephrology

Background:

• Partial nephrectomy (PN) is the standard treatment for small renal masses.
• Open partial nephrectomy (OPN) and robot-assisted partial nephrectomy (RAPN) are contemporary surgical approaches.
• Comparing outcomes between OPN and RAPN is crucial for clinical decision-making.

Purpose of the Study:

• To compare perioperative, pathological, and functional outcomes of OPN versus RAPN for suspected renal tumors.
• To evaluate the safety and efficacy of RAPN compared to OPN in large patient series from different institutions.

Main Methods:

• Retrospective, multicentre, international, matched-pair analysis.
• Comparison of 200 patients undergoing RAPN versus 200 patients undergoing OPN.
• Data sourced from an Italian observational registry (OPN) and a multicentre international database (RAPN).

Main Results:

• Warm ischaemia time was shorter in OPN (15.4 min) vs RAPN (19.2 min).
• Estimated blood loss was higher in OPN (150 mL) vs RAPN (100 mL).
• Postoperative complications were lower in RAPN (14%) vs OPN (21.5%), with no difference in major complications or positive surgical margins.

Conclusions:

• RAPN achieves equivalent perioperative, oncological, and functional outcomes to OPN.
• RAPN demonstrates a less invasive approach with reduced bleeding and postoperative complications.
• RAPN is a viable and potentially advantageous alternative to OPN for renal tumor treatment.