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Title: Strategies for success: a multi-institutional study on robot-assisted partial nephrectomy for complex renal lesions.
Austin Authors: Hennessey, Derek B;Wei, Gavin ;Moon, Daniel;Kinnear, Ned J;Bolton, Damien M ;Lawrentschuk, Nathan;Chan, Yee K
Affiliation: Epworth Richmond Hospital, Richmond, Victoria, Australia
Epworth Freemasons Hospital, East Melbourne, Victoria, Australia
Department of Surgery, Austin Health, The University of Melbourne, Heidelberg, Victoria, Australia
Division of Cancer Surgery, Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia
Olivia Newton-John Cancer Wellness and Research Centre, Austin Health, Heidelberg, Victoria, Australia
Issue Date: May-2018 2017-12-21
Publication information: BJU International 2018; 121 Suppl 3: 40-47
Abstract: To describe our technique, illustrated with images and videos, of robot-assisted partial nephrectomy (RAPN) for challenging renal tumours. A study of 249 patients who underwent RAPN in multiple institutions was performed. Patients were identified using prospective RAPN databases. Complex renal lesion were defined as those with a RENAL nephrometry score ≥10. Data were analysed and differences among groups examined. A total of 31 (12.4%) RAPNs were performed for complex renal tumours. The median (interquartile range [IQR]) patient age was 57 (50.5-70.5) years and 21 patients (67.7%) were men. The median (IQR) American Society of Anesthesiologists score was 2 (2-3). The median (IQR) operating time was 200 (50-265) min, warm ischaemia time was 23 (18.5-29) min, and estimated blood loss was 200 (50-265) mL. There were no intra-operative complications. Two patients (6.4%) had postoperative complications. One patient (3.2%) had a positive surgical margin. The median (IQR) length of stay was 3.5 (3-5) days and the median (IQR) follow-up was 12.5 (7-24) months. There were no recurrences. RAPN resulted in statistically significant changes in renal function 3 months after RAPN compared with preoperative renal function (P < 0.001). Our results showed that RAPN was a safe approach for selected patients with complex renal tumours and may facilitate tumour resection and renorrhaphy for challenging cases, offering a minimally invasive surgical option for patients who may otherwise require open surgery.
DOI: 10.1111/bju.14059
ORCID: 0000-0001-8553-5618
PubMed URL: 29072806
Type: Journal Article
Subjects: RENAL score
complex renal tumour
nephron sparing surgery
robotic partial nephrectomy
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