Partial nephrectomy for hilar tumors: comparison of conventional open and robot-assisted approaches

To characterize clinical advantages in robot-assisted partial nephrectomy (RAPN) for targeting renal hilar tumors, and compare them with those of open PN (OPN).

This study included 31 consecutive patients with renal hilar tumors, consisting of 15 and 16 who received OPN and RAPN, respectively, between January 2012 and May 2014. The perioperative and oncological outcomes of the two approaches were compared. In this series, a hilar tumor was defined as a renal cortical tumor located in the renal hilum that was shown, by preoperative imaging, to be in direct physical contact with the renal artery and/or vein.

There were no significant differences between demographic variables of the OPN and RAPN groups. Intended surgical procedures were successfully completed for all 31 cases. Despite lack of a significant difference between ischemia times in the two groups, operative time for RAPN was significantly longer than for OPN, and estimated blood loss during RAPN was significantly less than that during OPN. There were no significant differences between incidence of postoperative complications or percentage decrease in estimated glomerular filtration rate 4 weeks after surgery in the two groups. Indicators of postoperative recovery seemed to favor RAPN compared with OPN, with significant differences. No patient in either group was pathologically diagnosed with a positive surgical margin.

These findings suggest that, compared with OPN, RAPN is an effective, safe, and less invasive surgical option for renal hilar tumors.