[Robot-Assisted Partial Nephrectomy for Renal Tumor ≤7 cm in Diameter]

Area of Science:

• Urology
• Minimally Invasive Surgery
• Oncology

Background:

• Robot-assisted partial nephrectomy (RAPN) and laparoscopic partial nephrectomy (LPN) are surgical options for cT1 renal tumors.
• Comparing perioperative outcomes is crucial for determining the optimal surgical approach.
• The trifecta outcome (short ischemic time, negative margins, no complications) is a key metric for successful partial nephrectomy.

Purpose of the Study:

• To compare the perioperative results of RAPN versus LPN for cT1 renal tumors.
• To evaluate the trifecta achievement rates for both surgical techniques.

Main Methods:

• A retrospective study of 63 patients with cT1 renal tumors (≤7cm) undergoing either LPN (30 cases) or RAPN (33 cases) between August 2015 and March 2018.
• Patient demographics, tumor characteristics (size, RENAL nephrometry score), and perioperative outcomes were analyzed.
• Trifecta achievement was defined as ischemic time < 25 min, no positive surgical margin, and no perioperative complications within 4 weeks.

Main Results:

• No significant differences in patient age, BMI, gender, or tumor side were observed between the groups.
• RAPN demonstrated a significantly shorter warm ischemic time (12.7 min vs. 19.9 min, P=0.0007) and less estimated blood loss (58.6 ml vs. 160.3 ml, P=0.0005) compared to LPN.
• The trifecta achievement rate was significantly higher for RAPN (93.9%) than for LPN (66.7%).

Conclusions:

• Robot-assisted partial nephrectomy (RAPN) offers superior perioperative outcomes compared to laparoscopic partial nephrectomy (LPN) for cT1 renal tumors.
• Shorter ischemic times and reduced blood loss contribute to the improved trifecta achievement rates with RAPN.
• RAPN is a viable and effective surgical option for selected cT1 renal tumors.