Open versus robotic partial nephrectomy in obese patients: a multi-institutional propensity score-matched analysis...

Area of Science:

• Urology
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Limited evidence exists comparing robotic partial nephrectomy (RPN) and open partial nephrectomy (OPN) in obese patients (BMI ≥ 30 kg/m²).
• Obesity presents unique challenges in partial nephrectomy procedures.

Purpose of the Study:

• To compare the perioperative and oncological outcomes of RPN versus OPN in obese patients.
• To evaluate the safety and efficacy of minimally invasive versus traditional open partial nephrectomy in a specific patient population.

Main Methods:

• Retrospective analysis of prospectively collected data from 1277 obese patients undergoing partial nephrectomy (PN) between 2009-2017.
• Propensity-score matching was used to adjust for confounders, comparing 166 RPN patients with 166 OPN patients.
• Perioperative outcomes, disease-free survival (DFS), and overall survival (OS) were analyzed.

Main Results:

• RPN group showed significantly lower overall complication rates (25% vs. 37%) and major complication rates (10% vs. 21%) compared to OPN.
• Length of stay was significantly shorter for RPN patients (p < 0.001).
• No significant differences were observed in warm ischemia time, estimated glomerular filtration rate (eGFR) change, or positive surgical margins between the groups.

Conclusions:

• Robotic partial nephrectomy (RPN) is associated with improved perioperative outcomes, including reduced complications and shorter hospital stays, compared to open partial nephrectomy (OPN) in obese individuals.
• Oncological outcomes, including disease-free and overall survival, are comparable between RPN and OPN in this patient cohort.