Clinical Edge

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Robotic Partial Nephrectomy for Large Renal Masses

BJU Int; ePub 2018 Jan 22; Delto, Paulucci, et al

Robotic partial nephrectomy appears to be a reasonable option for certain renal masses, provided that an experienced surgeon performs the procedure at a center that can manage postoperative complications, researchers concluded after conducting an analysis involving nearly 1,800 individuals. Participants had cT1a (n=1358), cT1b (n=379), or cT2a (n=41) renal masses. Investigators looked at how intra and postoperative outcomes in patients with cT2a masses compared to those with the other 2 mass types. Among the results:

  • Performing robotic surgery on cT2a vs cT1a masses resulted in a 12% longer operative time, 32% increase in estimated blood loss, 7% increase in ischemia time, nearly 4-fold higher odds of acute kidney injury at discharge, and a nearly 11-fold higher recurrence risk.
  • Performing the procedure on cT2a vs cT1b masses resulted in a 12% increase in blood loss.
  • Operative time and recurrence risk were not statistically different.
  • Complications, positive margins, length of stay, and renal function decline up to 2 years post-procedure were not statistically different.

Citation:

Delto J, Paulucci D, Helbig M, et al. Robotic partial nephrectomy for large renal masses: A multi-institutional series. [Published online ahead of print January 22, 2018]. BJU Int. doi:10.1111/bju.14139.

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