Perioperative, Functional, and Oncological Outcomes of Robotic-Assisted Partial Nephrectomy in 1,267 Indian Patients:...

Robotic-assisted partial nephrectomy (RPN) is increasingly recognized as an effective treatment for small renal masses. This study aims to highlight the therapeutic benefits of RPN for both small and relatively larger renal masses in the Indian population.

A retrospective chart review was conducted on patients who underwent RPN using the da Vinci surgical system between September 2010 and September 2022 across 14 centers located in various cities of India, including Ahmedabad, Bengaluru, Chandigarh, Chennai, Delhi, Gurugram, Hyderabad, Kochi, and Nadiad. Data on demographics, medical history, clinical characteristics, and perioperative, functional, and oncological outcomes were extracted from medical records and analyzed statistically.

A total of 1,267 patients were included in the study, with 757 in the T1a tumor group and 510 in the T1b+T2 tumor group. In terms of baseline characteristics, the two groups showed a significant difference (p < 0.001) in renal nephrometry score (RENAL score). The mean operating room time (201.31 ± 77.57 vs. 191.06 ± 74.51; p = 0.0021) and warm ischemia time (25.21 ± 8.08 vs. 22.51 ± 7.95; p < 0.001) were significantly higher in the T1b+T2 tumor groups. Other outcomes were comparable, namely, length of hospital stay (4.21 ± 2.47 vs. 4.05 ± 2.30 days; p = 0.2459), postoperative complications (3.33% vs. 2.11%; p = 0.181), conversion rates (0% vs. 0%), and surgical margins (3.04 vs. 4.31%, p = 0.229). There was no difference in recurrence rates, and no significant differences were observed in the functional outcomes between the two groups.

RPN provides encouraging surgical, oncological, and functional outcomes for both T1a and T1b+T2 renal masses, enabling nephron-sparing surgery and early recovery of renal function.