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R-LESS partial nephrectomy trifecta outcome is inferior to multiport robotic partial nephrectomy: comparative
Christos Komninos1, Tae Young Shin2, Patrick Tuliao3
1Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, South Korea; Department of Urology, General Hospital of Nikaia 'St. Panteleimon', Athens, Greece.
European Urology
|November 27, 2013
Summary
Multiport robotic partial nephrectomy (RPN) achieved trifecta outcomes more often than robotic laparoendoscopic single-site (R-LESS) PN. R-LESS PN may suit patients with smaller tumors and fewer complex features.
Area of Science:
- Urology
- Surgical Oncology
- Minimally Invasive Surgery
Background:
- Trifecta achievement in partial nephrectomy (PN) involves warm ischemia time ≤ 20 min, negative surgical margins, and no complications.
- Robotic PN offers potential advantages in achieving these outcomes.
Purpose of the Study:
- To compare trifecta achievement rates between multiport robotic PN (RPN) and robotic laparoendoscopic single-site (R-LESS) PN.
- To evaluate perioperative and postoperative outcomes between the two robotic PN approaches.
Main Methods:
- Retrospective analysis of 167 patients undergoing RPN between 2006 and 2012.
- Comparison of trifecta achievement and perioperative outcomes between RPN and R-LESS PN groups.
- Statistical analysis including univariable, multivariable, and subgroup analyses.
Main Results:
- Trifecta was achieved in 42.7% of RPN patients versus 25.6% of R-LESS PN patients (p=0.021).
- R-LESS PN was associated with longer operative time, longer warm ischemia time, and greater eGFR change.
- No significant differences in hospitalization, blood loss, postoperative eGFR, margin status, or complications were observed.
Conclusions:
- Multiport RPN demonstrated superior trifecta achievement compared to R-LESS PN.
- R-LESS PN may be a viable option for select patients with smaller tumors and less complex renal masses.
