Robotic partial nephrectomy for cystic renal masses: a comparative analysis of a matched-paired cohort

To compare the outcomes of robotic partial nephrectomy (RPN) for cystic and solid renal neoplasms.

Our RPN database was queried to identify consecutive patients who underwent RPN for cystic and solid renal masses in the period between July 2007 and July 2013. Cystic renal masses were diagnosed on cross-sectional imaging (computed tomography or magnetic resonance imaging). Matching was done between the patients with cystic renal masses and patients with solid renal masses (1:1 matching) by age, gender, tumor size, and nephrometry score.

Of 647 cases, 55 patients with cystic masses (group 1) were matched with 55 patients with solid tumors (group 2). There was no cyst rupture or positive surgical margin observed in group 1. The volume of resected rim of healthy renal parenchyma surrounding the tumor was the same for both groups (P=.9). There was no difference between the groups in terms of percentage of glomerular filtration rate preservation postoperatively (85% vs 86%; P=.94). There was no difference in term of overall complications between the 2 groups. Thirty patients (54.5%) in group 1 and 47 patients (85.5%) in group 2 had renal cell carcinoma (P=.0001).

RPN can be safely and effectively performed when treating a suspicious cystic renal neoplasm with outcomes resembling those obtained for solid masses. Thus, when a cystic renal mass in encountered, nephron-sparing surgery can be offered and RPN represents an effective tool for this approach.