World Journal of Urology

, Volume 35, Issue 1, pp 73–80 | Cite as

Robotic and open partial nephrectomy for complex renal tumors: a matched-pair comparison with a long-term follow-up

  • Yubin Wang
  • Jinkai Shao
  • Xin Ma
  • Qingshan Du
  • Huijie Gong
  • Xu ZhangEmail author
Original Article



To compare the surgical, functional and oncological outcomes of patients undergoing robotic partial nephrectomy (RPN) or open partial nephrectomy (OPN) for moderately or highly complex tumors (RENAL nephrometry score ≥7).


A retrospective, matched-pair analysis was performed for 380 patients who underwent either RPN (n = 190) or OPN (n = 190) for a complex renal mass in different institutions. Surgical data, pathological variables, complications and functional and oncological outcomes were reviewed.


RPN is associated with less estimated blood loss (EBL) (196.8 vs 240.8 ml; p < 0.001), shorter length of hospital stay (7.8 vs 9.2 days; p < 0.001) and lower rate of postoperative complications (15.8 vs 28.9 %; p = 0.002). Patients undergoing RPN required more direct cost. In multivariable models, surgical approach was the significant predictor for the occurrence of postoperative minor complications and postoperative wound pain. Median follow-up for RPN and OPN was 49 months and 52 months, respectively. The decline of estimated glomerular filtration at the last available follow-up (RPN: 8.7 %; OPN: 10 %) was similar (p = 0.125). The 5-year recurrence-free survival rate was 95.1 % for RPN and 92.7 % for OPN (p = 0.48).


RPN provides acceptable and comparable results in terms of perioperative, functional and oncological outcomes compared to OPN for complex renal tumors with RENAL score ≥7. Moreover, RPN is a less invasive approach with the benefit of shorter length of hospital stay, less EBL and lower rate of postoperative complications.


Robotics Partial nephrectomy Renal cell carcinoma RENAL nephrometry score 



American Society of Anesthesiologists


Body mass index


Charlson comorbidity index


Confidence interval


Estimated blood loss


Estimated glomerular filtration rate


Laparoscopic partial nephrectomy


Modification of diet in renal disease


Open partial nephrectomy


Odds ratio


Partial nephrectomy


Positive surgical margins


Recurrence-free survival


Radical nephrectomy


Robotic partial nephrectomy


Standard deviation


Warm ischemia time


Authors’ contribution

Yubin Wang and Xu Zhang developed the protocol/project; Yubin Wang, Jinkai Shao and Xin Ma contributed to the data collection or management; Qingshan Du and Huijie Gong analyzed the data; Yubin Wang and Qingshan Du wrote and edited the manuscript; Xu Zhang and Jinkai Shao reviewed the manuscript.

Compliance with ethical standard

Conflict of interest

All authors certify that there is no actual or potential conflict of interest in relation to this article.

Ethical standards

The data were obtained from a prospectively maintained database approved by institutional review board and the local ethics committee, and informed consent was collected for all patients.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Yubin Wang
    • 1
  • Jinkai Shao
    • 1
  • Xin Ma
    • 2
  • Qingshan Du
    • 2
  • Huijie Gong
    • 2
  • Xu Zhang
    • 2
    Email author
  1. 1.Department of UrologyShanxi Provincial People’s HospitalTaiyuanChina
  2. 2.Department of UrologyChinese People’s Liberation Army General HospitalBeijingPeople’s Republic of China

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