Comparing open and robot-assisted partial nephrectomy - a single institution report

Area of Science:

• Urology
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Open partial nephrectomy (OPN) was the standard for T1 localized renal tumors.
• Robot-assisted partial nephrectomy (RAPN) emerged as an alternative, leading to OPN's reduced use.
• This study retrospectively compares OPN and RAPN outcomes for suspected renal carcinoma.

Purpose of the Study:

• To compare the efficacy and safety of OPN versus RAPN for suspected renal tumors.
• To evaluate outcomes including operative time, blood loss, length of stay, and surgical margins.
• To assess complication rates between the two surgical approaches.

Main Methods:

• Retrospective analysis of 197 patients undergoing partial nephrectomy (75 OPN, 122 RAPN) between 2010-2020.
• Preoperative tumor scoring using the RENAL nephrometry system.
• Postoperative complication assessment using the Clavien-Dindo classification within 30 days.

Main Results:

• No significant differences in patient demographics, BMI, or ASA score between OPN and RAPN groups.
• RAPN group had a significantly longer operative time (144.5 min) than OPN (81 min).
• RAPN group demonstrated a shorter length of stay (3 days vs. 6 days) and a lower positive surgical margin rate (4.2% vs. 21.6%) compared to OPN.
• No significant difference in perioperative blood loss or Clavien-Dindo complications between groups.

Conclusions:

• Introduction of RAPN resulted in a shorter length of stay.
• RAPN led to a significant reduction in positive surgical margins.
• RAPN was implemented without an increase in complications compared to OPN.