A Modified "Cross-Stitch" Suturing Technique Is Associated with Shorter Warm Ischemia Time in Robot-Assisted Partial...

Area of Science:

• Urology
• Surgical Oncology
• Robotic Surgery

Background:

• Robot-assisted partial nephrectomy (RAPN) is a standard treatment for localized renal cell carcinoma.
• Suturing techniques are critical for minimizing complications and preserving renal function during RAPN.
• Traditional double-layer suturing is commonly used, but improved methods are being explored.

Purpose of the Study:

• To compare the efficacy of a novel
• cross-stitch
• suturing technique (CST) against traditional double-layer suturing in RAPN.
• To evaluate perioperative indicators, early renal function, and postoperative complications.

Main Methods:

• Retrospective analysis of 89 patients undergoing RAPN, with 58 in the double-layer group and 31 in the CST group.
• 1:1 propensity score matching (PSM) was used to balance baseline characteristics between groups.
• Multivariate regression models adjusted for residual confounders to compare outcomes.

Main Results:

• After PSM (26 patients per group), the CST group demonstrated significantly shorter operative time (111.1 vs. 133.4 minutes, p=0.002) and warm ischemia time (WIT) (15.4 vs. 20.5 minutes, p<0.001).
• No significant differences were found in estimated blood loss, postoperative hospital stay, positive margin rate, or postoperative complications.
• Trifecta achievement rate showed no statistically significant difference between the groups (p=0.07).

Conclusions:

• The modified CST is associated with reduced operative time and WIT in RAPN for localized renal tumors.
• The technique may be suitable for moderately complex renal tumors.
• Further validation is required as no significant differences in postoperative renal function or trifecta were observed post-matching.