Influence of Robot-Assisted Partial Nephrectomy on Long-Term Renal Function as Assessed Using 99m-Tc DTPA Renal...

The long-term split renal function after robot-assisted partial nephrectomy (RAPN) is yet to be elucidated. This study aimed to assess long-term renal function of RAPN, using renal scintigraphy, and to identify clinical factors related to deterioration of renal function on the affected side of the kidney. RAPN for small tumors was performed, and split renal function was evaluated using 99m-Tc DTPA renal scintigraphy before and 1 year after surgery. Clinical factors (age, gender, body mass index, tumor side, presence of urinary protein, diabetes, hypertension, and dyslipidemia), perioperative factors (renal nephrectomy score [RNS], tumor diameter, overall surgery duration, console time, warm ischemic time, and amount of bleeding), and renal function (estimated glomerular filtration rate [eGFR] and glomerular filtration rate [GFR] measured using scintigraphy on both the affected and contralateral kidneys) were analyzed. Sixty-six patients were included in the study. The median eGFR decreased from 71.9 to 63.9 mL/min after 1 year (p < 0.001), accounting for a mean loss of 10.1%. In scintigraphy examination, the median GFR on the affected kidney side decreased from 41.1 to 33.7 mL/min after 1 year (p < 0.001), accounting for a mean loss of 16.8%. RNS was significantly associated with renal function. Among RNS factors, the N factor is associated with renal function after RAPN. RNS, particularly the N factor, possibly influences the long-term deterioration of renal function after RAPN.