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Selective Suturing or Sutureless Technique in Robot-assisted Partial Nephrectomy: Results from a Propensity-score
Rui Farinha1, Giuseppe Rosiello2, Artur De Oliveira Paludo3
1Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium; ORSI Academy, Melle, Belgium.
European Urology Focus
|March 29, 2021
Summary
A new selective-suturing or sutureless technique for robot-assisted partial nephrectomy (RAPN) reduces operative time and hospital stay. This approach is feasible, safe, and shows promising functional outcomes, potentially preserving renal function post-surgery.
Area of Science:
- Urology
- Surgical Oncology
- Nephrology
Background:
- Robot-assisted partial nephrectomy (RAPN) can lead to functional renal decline.
- Intraparenchymal vessel injuries during renorrhaphy risk parenchyma loss.
- A novel surgical technique aims to mitigate these risks.
Purpose of the Study:
- Compare perioperative outcomes of selective-suturing or sutureless RAPN (suRAPN) versus standard RAPN (stRAPN).
- Evaluate the impact of suRAPN on complications, operative time, length of stay, trifecta achievement, and acute kidney injury (AKI).
- Assess the effect on long-term renal function.
Main Methods:
- Retrospective analysis of 92 patients undergoing RAPN for renal masses.
- Propensity-score matching to compare suRAPN (29 patients) and stRAPN (63 patients).
- Outcomes included operative time, blood loss, complications, trifecta, AKI, and estimated glomerular filtration rate (eGFR) changes.
Main Results:
- suRAPN showed significantly shorter operative time (110 vs 150 min) and length of stay (2 vs 3 days).
- Complication rates and AKI incidence were similar between groups.
- The decrease in eGFR at 6 months was significantly lower in the suRAPN group (-5.2% vs -9.1%).
Conclusions:
- Selective-suturing or sutureless RAPN is a feasible and safe technique.
- suRAPN demonstrates a lower-impact surgical profile with promising functional outcomes.
- Further randomized trials are necessary to confirm long-term functional benefits.
