Related Experiment Video
Updated: Aug 22, 2026
Retzius-Sparing Robot-Assisted Radical Prostatectomy
Published on: May 19, 2022
Renal functional and surgical outcomes after robot-assisted partial nephrectomy for hilar vs non-hilar tumors:
Takuto Hara1, Kotaro Suzuki2, Naoto Wakita2
1Department of Urology, Kobe University Graduate School of Medicine, Kobe 6500017, Hyōgo, Japan. supermarimo85@carp.kobe-u.ac.jp.
Background:
Robot-assisted partial nephrectomy (RAPN) is well-suited for managing complex renal tumors, including those located in the renal hilum. However, studies directly comparing RAPN outcomes for hilar and non-hilar tumors, particularly in terms of comprehensive measures, such as trifecta and pentafecta, are still limited.
Aim:
To evaluate whether tumor location in the renal hilum independently influences surgical and renal functional outcomes after RAPN, as assessed by trifecta and pentafecta criteria.
Methods:
This single-center retrospective cohort study evaluated outcomes of RAPN for hilar and non-hilar renal tumors treated from April 2016 to June 2023. Eligible patients had tumors ≤ 7 cm, no metastasis, and at least one year of follow-up. Propensity score matching was applied. Primary endpoints were trifecta and pentafecta achievement. All procedures were performed under ischemia without early unclamping. Multivariate logistic regression identified predictors of outcome achievement.
Results:
Of 350 patients, 324 met the inclusion criteria, consisting of 60 hilar and 264 non-hilar tumors. Trifecta achievement was similar between hilar (63.3%) and non-hilar groups (64.0%), with no significant differences in ischemia time, positive margins, or major complications. Pentafecta achievement rates were also similar (20.0% hilar vs 14.0% non-hilar, P = 0.237). Multivariate analysis identified R score, N score, and L score as predictors of pentafecta non-achievement. Surgeon experience and hilar tumor presence were predictors of pentafecta achievement. Hilar tumor location was not an independent determinant in the propensity-matched analysis, suggesting that the adjustment methods and sample size may have influenced the results.
Conclusion:
RAPN achieved comparable trifecta and pentafecta outcomes for hilar and non-hilar tumors, supporting its viability for complex hilar tumors when appropriate patient selection and surgical experience are ensured.
