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Updated: Jun 6, 2025

Retzius-Sparing Robot-Assisted Radical Prostatectomy
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Robot-assisted partial nephrectomy of multiple tumors: a multicenter analysis.

Pouriya Faraj Tabrizi1, Philip Zeuschner2, Olga Katzendorn1

  • 1Hannover Medical School, Department of Urology and Urological Oncology, Hannover, Germany.

Minerva Urology and Nephrology
|November 28, 2024
PubMed

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Tumor anatomy predictors of mic and trifecta achievement in robot-assisted partial nephrectomy: a multicenter analysis stratified by PADUA score.

Journal of robotic surgery·2026
Summary

Robot-assisted partial nephrectomy for multiple kidney tumors is feasible. Postoperative renal function is mainly impacted by unmodifiable patient factors, but cumulative warm ischemia time is a key surgical factor.

Area of Science:

  • Urology
  • Surgical Oncology
  • Nephrology

Background:

  • Robot-assisted partial nephrectomy (RAPN) is a growing procedure for complex cases, including multiple renal masses.
  • Evaluating factors affecting kidney function after RAPN for multiple tumors is crucial for patient outcomes.

Purpose of the Study:

  • To identify factors influencing postoperative renal function (PRF) after ipsilateral robot-assisted partial nephrectomy of multiple tumors (iRAPN-MT).
  • To analyze the impact of patient, surgical, and tumor characteristics on PRF and acute kidney injury.

Main Methods:

  • Retrospective analysis of perioperative data from 132 patients undergoing trans- or retroperitoneal iRAPN-MT for two or more renal tumors.
  • Investigation of influencing factors on PRF and acute kidney injury using RIFLE and trifecta criteria.

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  • Uni- and multivariate regression analyses to assess patient-, surgery-, and tumor-related factors.

    • Main Results:

    • 57% of patients achieved trifecta outcomes.
    • Cumulative warm ischemia time (WITsum), BMI, and preoperative eGFR impacted eGFR loss.
    • BMI and Charlson Comorbidity Index predicted the lowest RIFLE stage during hospitalization.

    Conclusions:

    • Ipsilateral robot-assisted partial nephrectomy of multiple renal masses (iRAPN-MT) is feasible with good trifecta rates.
    • Unmodifiable patient factors are independent predictors of PRF impairment.
    • Cumulative warm ischemia time (WITsum) is a significant surgery-related factor affecting PRF.