Perioperative outcomes of open and robot-assisted partial nephrectomy in patients with renal tumors of moderate to high complexity
Objective: To compare the perioperative outcomes of patients with complex renal tumors treated with open versus robot-assisted partial nephrectomy. Methods: This retrospective study included 273 patients diagnosed with localized renal tumors at our institution between January 2007 and October 2020....
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-06-01
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| Series: | Asian Journal of Surgery |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1015958422014361 |
| _version_ | 1797816056056643584 |
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| author | Shunta Hori Keiichi Sakamoto Kenta Onishi Mitsuru Tomizawa Yosuke Morizawa Daisuke Gotoh Yasushi Nakai Makito Miyake Kazumasa Torimoto Tatsuo Yoneda Nobumichi Tanaka Kiyohide Fujimoto |
| author_facet | Shunta Hori Keiichi Sakamoto Kenta Onishi Mitsuru Tomizawa Yosuke Morizawa Daisuke Gotoh Yasushi Nakai Makito Miyake Kazumasa Torimoto Tatsuo Yoneda Nobumichi Tanaka Kiyohide Fujimoto |
| author_sort | Shunta Hori |
| collection | DOAJ |
| description | Objective: To compare the perioperative outcomes of patients with complex renal tumors treated with open versus robot-assisted partial nephrectomy. Methods: This retrospective study included 273 patients diagnosed with localized renal tumors at our institution between January 2007 and October 2020. Patients with moderate to high complexity tumors based on the RENAL nephrometry score were included. Perioperative outcomes were compared between open and robot-assisted partial nephrectomy patients. Remnant renal function was defined as the estimated glomerular filtration rate at 12 months after surgery. Results: Open and robot-assisted partial nephrectomy were performed in 43 and 77 patients, respectively. There was no significant difference in overall, cancer-specific, recurrence-free, and metastasis-free survival between the two groups. Remnant renal function was significantly better preserved in the open group, and body mass index was identified as an independent predictive factor (odds ratio 3.05, P = 0.017). Ischemia or type of surgery were not related to remnant renal function. The trifecta achievement rate was 51.2% in the open group and 71.4% in the robot-assisted group (P = 0.031), and the incidence of complications was significantly higher in the open partial nephrectomy group (P = 0.0030). Multivariate analysis revealed that open partial nephrectomy was an independent predictive factor for the incidence of complications (odds ratio 3.92, P = 0.0020). Conclusion: Robot-assisted partial nephrectomy can provide good and acceptable oncological and functional outcomes with fewer complications in patients with more complex renal tumors. Further research is needed to establish appropriate treatment strategies and guidelines in current clinical practice. |
| first_indexed | 2024-03-13T08:32:02Z |
| format | Article |
| id | doaj.art-72f29e67ba234629abb4bf448555d565 |
| institution | Directory Open Access Journal |
| issn | 1015-9584 |
| language | English |
| last_indexed | 2024-03-13T08:32:02Z |
| publishDate | 2023-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Asian Journal of Surgery |
| spelling | doaj.art-72f29e67ba234629abb4bf448555d5652023-05-31T04:43:12ZengElsevierAsian Journal of Surgery1015-95842023-06-0146623102318Perioperative outcomes of open and robot-assisted partial nephrectomy in patients with renal tumors of moderate to high complexityShunta Hori0Keiichi Sakamoto1Kenta Onishi2Mitsuru Tomizawa3Yosuke Morizawa4Daisuke Gotoh5Yasushi Nakai6Makito Miyake7Kazumasa Torimoto8Tatsuo Yoneda9Nobumichi Tanaka10Kiyohide Fujimoto11Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, JapanDepartment of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, JapanDepartment of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, JapanDepartment of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, JapanDepartment of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, JapanDepartment of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, JapanDepartment of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, JapanDepartment of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, JapanDepartment of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, JapanDepartment of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, JapanDepartment of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, JapanCorresponding author. Department of Urology, Nara Medical University 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.; Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, JapanObjective: To compare the perioperative outcomes of patients with complex renal tumors treated with open versus robot-assisted partial nephrectomy. Methods: This retrospective study included 273 patients diagnosed with localized renal tumors at our institution between January 2007 and October 2020. Patients with moderate to high complexity tumors based on the RENAL nephrometry score were included. Perioperative outcomes were compared between open and robot-assisted partial nephrectomy patients. Remnant renal function was defined as the estimated glomerular filtration rate at 12 months after surgery. Results: Open and robot-assisted partial nephrectomy were performed in 43 and 77 patients, respectively. There was no significant difference in overall, cancer-specific, recurrence-free, and metastasis-free survival between the two groups. Remnant renal function was significantly better preserved in the open group, and body mass index was identified as an independent predictive factor (odds ratio 3.05, P = 0.017). Ischemia or type of surgery were not related to remnant renal function. The trifecta achievement rate was 51.2% in the open group and 71.4% in the robot-assisted group (P = 0.031), and the incidence of complications was significantly higher in the open partial nephrectomy group (P = 0.0030). Multivariate analysis revealed that open partial nephrectomy was an independent predictive factor for the incidence of complications (odds ratio 3.92, P = 0.0020). Conclusion: Robot-assisted partial nephrectomy can provide good and acceptable oncological and functional outcomes with fewer complications in patients with more complex renal tumors. Further research is needed to establish appropriate treatment strategies and guidelines in current clinical practice.http://www.sciencedirect.com/science/article/pii/S1015958422014361Perioperative complicationRemnant renal functionRenal cell carcinomaRobot-assisted partial nephrectomyTrifecta achievement |
| spellingShingle | Shunta Hori Keiichi Sakamoto Kenta Onishi Mitsuru Tomizawa Yosuke Morizawa Daisuke Gotoh Yasushi Nakai Makito Miyake Kazumasa Torimoto Tatsuo Yoneda Nobumichi Tanaka Kiyohide Fujimoto Perioperative outcomes of open and robot-assisted partial nephrectomy in patients with renal tumors of moderate to high complexity Asian Journal of Surgery Perioperative complication Remnant renal function Renal cell carcinoma Robot-assisted partial nephrectomy Trifecta achievement |
| title | Perioperative outcomes of open and robot-assisted partial nephrectomy in patients with renal tumors of moderate to high complexity |
| title_full | Perioperative outcomes of open and robot-assisted partial nephrectomy in patients with renal tumors of moderate to high complexity |
| title_fullStr | Perioperative outcomes of open and robot-assisted partial nephrectomy in patients with renal tumors of moderate to high complexity |
| title_full_unstemmed | Perioperative outcomes of open and robot-assisted partial nephrectomy in patients with renal tumors of moderate to high complexity |
| title_short | Perioperative outcomes of open and robot-assisted partial nephrectomy in patients with renal tumors of moderate to high complexity |
| title_sort | perioperative outcomes of open and robot assisted partial nephrectomy in patients with renal tumors of moderate to high complexity |
| topic | Perioperative complication Remnant renal function Renal cell carcinoma Robot-assisted partial nephrectomy Trifecta achievement |
| url | http://www.sciencedirect.com/science/article/pii/S1015958422014361 |
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