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Robot-Assisted Kidney Transplantation
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'Trifecta' outcomes of robot-assisted partial nephrectomy: a large Japanese multicenter study
Junya Furukawa1,2, Hiroomi Kanayama3,4, Haruhito Azuma3,5
1Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan. jfuru@med.kobe-u.ac.jp.
International Journal of Clinical Oncology
|November 3, 2019
Summary
Robot-assisted partial nephrectomy (RAPN) shows safe outcomes for small kidney tumors. However, achieving optimal results (Trifecta) is less likely for larger or centrally located tumors.
Area of Science:
- Urology
- Surgical Oncology
- Robotic Surgery
Background:
- Robot-assisted partial nephrectomy (RAPN) is increasingly used for small renal masses.
- Evaluating early surgical outcomes is crucial for establishing best practices.
Purpose of the Study:
- To assess the early surgical outcomes of RAPN for small renal masses in a large Japanese multicenter cohort.
- To identify factors influencing Trifecta achievement in RAPN.
Main Methods:
- Retrospective review of 804 consecutive RAPN cases across 42 Japanese institutes (2011-2016).
- Analysis of clinical, pathological, and perioperative data.
- Univariable and multivariable analyses to predict Trifecta achievement.
Main Results:
- Median tumor size was 2.6 cm, median RENAL score was 7.
- Low rates of conversion (1.0%), major complications (5.8%), and positive surgical margins (1.1%).
- Trifecta achieved in 62.1%; lower rates for T1b (48.4%) and hilar tumors (50.0%).
Conclusions:
- RAPN offers safe oncological and functional outcomes for small renal masses.
- Tumor diameter, estimated blood loss, and hilar location negatively impact Trifecta achievement.
- Careful patient selection is needed for T1b or hilar tumors to optimize outcomes.
