Korean J Urol Oncol.  2017 Dec;15(3):172-177. 10.22465/kjuo.2017.15.3.172.

Comparison of 5-Year Outcomes of Robot-Assisted Laparoscopic and Laparoscopic Partial Nephrectomy in Patients With Localized Renal Cell Carcinoma

• Lee CU
• Kang M
• Sung HH
• Jeon HG
• Han DH
• Jeong BC
• Jeon SS
• Lee HM
• Choi HY
• Seo SI

• KMID: 2402600
• DOI: http://doi.org/10.22465/kjuo.2017.15.3.172

Abstract

PURPOSE
To compare the 5-year oncologic and functional outcomes of robot-assisted laparoscopic partial nephrectomy (RALPN) and laparoscopic partial nephrectomy (LPN) as treatment for localized renal cell carcinoma (RCC).
MATERIALS AND METHODS
We analyzed the records of 181 patients with localized RCC who underwent RALPN (n=97) or LPN (n=84) between 2007 and 2011. Demographic and preoperative data with estimated glomerular filtration rate (eGFR), intraoperative data including warm ischemic time (WIT) and complications, oncologic outcomes (recurrence, metastasis), and rate of eGFR preservation at most recent follow-up were examined.
RESULTS
WIT was shorter in the RALPN group (27±9.1 minutes) than the LPN group (31±10 minutes, p=0.019). Intraoperative complication rates were also lower in RALPN patients than LPN patients (4.1% vs. 14.3%). The eGFR preservation rate was higher in the RALPN group (84.6%) than in the LPN group (81.5%, p=0.049). Particularly, a relatively high difference in the eGFR preservation rate was observed in the RALPN group compared with the LPN group according to R.E.N.A.L. score 7-10 values (RALPN, 86.5±12.9 vs. LPN, 76.7±16.0; p=0.003). During the follow-up period, there was no local recurrence in either group and distant metastases only occurred in one patient in the RALPN group and in 2 patients in the LPN group.
CONCLUSIONS
RALPN and LPN showed similar 5-year oncologic outcomes, but RALPN was superior to LPN in terms of WIT, intraoperative complications, and long-term eGFR preservation rate, especially in complex cases.

Keyword

Renal cell carcinoma; Robot-assisted laparoscopic partial nephrectomy; Laparoscopic partial nephrectomy; Oncologic outcomes; Functional outcomes

MeSH Terms

Carcinoma, Renal Cell*
Follow-Up Studies
Glomerular Filtration Rate
Humans
Intraoperative Complications
Neoplasm Metastasis
Nephrectomy*
Recurrence
Warm Ischemia