Perioperative complications of robot-assisted partial nephrectomy

Area of Science:

• Urology
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Increasing incidence of renal cell carcinoma (RCC) and small renal masses (SRM) detected via imaging.
• Robot-assisted partial nephrectomy (RAPN) is favored over laparoscopic partial nephrectomy (LPN) for SRMs due to technical benefits and a shorter learning curve.
• Advancements in ablative therapies and ongoing debate regarding surgical intervention for SRMs necessitate a clear understanding of RAPN complications.

Purpose of the Study:

• To systematically review and evaluate the current literature on complications associated with Robot-assisted partial nephrectomy (RAPN).
• To compile reported intraoperative complications.
• To describe postoperative complications specific to conventional and nephron-sparing surgery (NSS) approaches and identify factors influencing these complications.

Main Methods:

• Comprehensive literature search of contemporary studies on RAPN for SRMs.
• Categorization and analysis of reported intraoperative complications.
• Detailed review of postoperative complications, distinguishing between conventional and NSS techniques.
• Assessment of perioperative factors linked to complication rates.

Main Results:

• Data on intraoperative complications during RAPN for SRMs were compiled.
• Postoperative complications, including those specific to NSS, were systematically described.
• Factors contributing to an increased risk of perioperative complications were identified and analyzed.
• The review synthesizes current evidence on the safety profile of RAPN in SRM management.

Conclusions:

• A thorough understanding of RAPN-associated complications is crucial given the rise in SRM detection and evolving treatment landscape for renal cell carcinoma.
• This review provides a comprehensive overview of intraoperative and postoperative complications, aiding surgeons in risk assessment and patient counseling.
• The findings support the imperative for continued research into optimizing RAPN outcomes and minimizing patient risk.