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A comparison of pathologic outcomes of matched robotic and open partial nephrectomies

Abstract

Purpose

Open partial nephrectomy (OPN) and robotic partial nephrectomy (RPN) are widely utilized techniques for small renal masses. The lack of tactile feedback and limitations of laparoscopy may result in differences in the surgical specimen that may impact oncologic outcome. We present postoperative pathological outcomes data in a cohort of patients matched for nephrometry score, tumor size, gender and age.

Materials and methods

We reviewed 81 patients who underwent partial nephrectomy between January 2003 and March 2010. Twenty-seven underwent RPN and 54 received OPN. Two OPN cases were matched for nephrometry score, tumor size, gender and age for each RPN. Postoperative pathological specimens were reviewed by a urologic pathologist regarding margin status, pathologic stage, histology, renal capsule violation, among other variables.

Results

Sixty-two (76.5 %) patients were found to have renal cell carcinoma on final pathology. Frozen sectioning with tumor bed sampling was intra-operatively employed in 70 cases (86.4 %). The overall positive margin occurrence was 1 of 81 patients, which occurred during an RPN for a hilar tumor and converted to radical nephrectomy to achieve negative clinical margins. Additionally, 14.8 % of OPN patients had renal capsule violation as compared to 3.7 % of RPN cases (p = 0.34). Importantly, the mean distance to the proximal margin edge for RPN specimens (2.77 mm) was equivalent to OPN (3.01 mm), p = 0.46.

Conclusion

When matched for nephrometry score, tumor size, gender and age, RPN produces similar pathological outcomes to OPN.

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Abbreviations

OPN:

Open partial nephrectomy

RPN:

Robotic partial nephrectomy

LPN:

Laparoscopic partial nephrectomy

RCC:

Renal cell carcinoma

BMI:

Body mass index

AML:

Angiomyolipoma

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Conflict of interest

The authors declare they have no conflict of interest.

Author information

Correspondence to Matthew J. Mellon.

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Mellon, M.J., Lucas, S.M., Kum, J.B.J. et al. A comparison of pathologic outcomes of matched robotic and open partial nephrectomies. Int Urol Nephrol 45, 381–385 (2013). https://doi.org/10.1007/s11255-013-0392-4

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Keywords

  • Margin
  • Partial nephrectomy
  • Pathology