Surgical and functional outcomes of repeat robot-assisted laparoscopic partial nephrectomy compared with repeat open...

Area of Science:

• Urology
• Surgical Oncology
• Nephrology

Background:

• Recurrent renal cell carcinoma (RCC) necessitates repeat nephron-sparing surgery (NSS).
• Comparing repeat open partial nephrectomy (reOPN) and robot-assisted laparoscopic partial nephrectomy (reRAPN) is crucial for optimizing patient outcomes.

Purpose of the Study:

• To evaluate and compare the surgical and functional outcomes of reOPN versus reRAPN.
• To determine the efficacy and safety of minimally invasive reRAPN for recurrent RCC.

Main Methods:

• Retrospective analysis of 39 patients (22 reOPN, 17 reRAPN) who underwent repeat NSS.
• Data collected included operative time, estimated blood loss, complication rates (Clavien-Dindo grade ≥2), and postoperative renal function (eGFR).
• Trifecta achievement (negative margins, no major complications, and normal renal function) was assessed.

Main Results:

• No significant differences in patient demographics, tumor characteristics, or nephrometry score.
• ReRAPN demonstrated significantly shorter operative times and less estimated blood loss compared to reOPN.
• Higher complication rates (Clavien-Dindo grade ≥2) were observed in the reOPN group.
• Trifecta achievement rates were significantly higher in the reRAPN group (64.7%) than in the reOPN group (27.3%).
• Postoperative renal function (eGFR decrease at 3 months) showed no significant difference between the groups.

Conclusions:

• ReRAPN is associated with a reduced surgical burden compared to reOPN.
• Both reOPN and reRAPN yield comparable postoperative renal functional outcomes.
• ReRAPN represents a valuable minimally invasive surgical option for managing recurrent renal cell carcinoma.