Feasibility and Safety of Repeat Robot-Assisted Partial Nephrectomy for Ipsilateral Local Recurrence: A Case Series

Area of Science:

• Urology
• Oncology
• Minimally Invasive Surgery

Background:

• Local recurrence of renal cell carcinoma after partial nephrectomy (PN) presents a challenge.
• Repeat robot-assisted partial nephrectomy (RAPN) is being explored as a salvage option.

Purpose of the Study:

• To assess the feasibility, safety, and short-term outcomes of repeat RAPN for ipsilateral renal cell carcinoma recurrence.
• To describe surgical strategies for repeat RAPN.

Main Methods:

• Retrospective analysis of eight patients undergoing repeat RAPN for ipsilateral local recurrence.
• Evaluation of perioperative outcomes, renal function, pathological findings, and intraoperative adhesion severity.

Main Results:

• Repeat RAPN was successfully performed in all patients with no conversion to open surgery.
• Median operative time was 157 min, warm ischemia time 15 min, and estimated blood loss 50 mL.
• No major complications occurred; all tumors had negative margins. No recurrence or metastasis observed at median 17.5-month follow-up. Severe adhesions were more frequent in patients not using anti-adhesion agents during initial PN.

Conclusions:

• Repeat RAPN is a feasible and safe salvage treatment for ipsilateral renal cell carcinoma recurrence post-PN.
• Acceptable early oncological and functional results were achieved.
• Use of anti-adhesion agents during initial PN may reduce difficulty in repeat surgery, warranting further investigation.