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Expanding utilization of robotic partial nephrectomy for clinical T1b and complex T1a renal masses

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Abstract

Introduction

Partial nephrectomy is the standard of care for cT1a renal masses, offering equivalent oncologic outcomes and lower renal function impairment when compared to radical nephrectomy, with excellent overall survival results. Robot-assisted partial nephrectomy (RAPN) allows to perform a precise tumor excision, simplifying the reconstruction steps of the procedure, especially in the treatment of complex or large renal tumors. Aim of this study was to summarize the available perioperative, functional, and oncological outcomes of RAPN performed for complex and/or large (cT1b) renal cell carcinoma (RCC).

Materials and methods

We performed a nonsystematic review of the literature using a free-text protocol in the Medline database, using the terms “robot-assisted partial nephrectomy” and “robotic partial nephrectomy.” Two Authors reviewed separately to select RAPN series reporting data about complex and cT1b RCC. Other significant studies cited in the reference lists of the selected papers were also evaluated.

Evidence synthesis

According to the currently available evidences, RAPN offers promising results in terms of perioperative, functional, and oncological outcomes for the conservative management of complex or large renal tumors, even when compared with open and laparoscopic partial nephrectomy. Robot-assisted procedure allows surgeons to treat large and challenging renal masses, even if with higher warm ischemia time, operating time, and estimated blood loss in comparison with those obtained for the treatment of smaller lesions.

Conclusions

In the hands of experienced surgeons, RAPN is a safe and reproducible approach for the treatment of cT1b and more challenging renal tumors, and could represent the way to expand the indications for minimally invasive conservative approach to RCC.

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Conflict of interest

I certify that there is no actual or potential conflict of interests in relation to this article.

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Authors and Affiliations

  1. OLV Robotic Surgery Institute, Moorselban 164, 9300, Aalst, Belgium

    Marco Borghesi, Melanie Gan, Alexandre Mottrie & Vincenzo Ficarra

  2. Department of Urology, University of Bologna, Palagi 9 Street, 40138, Bologna, Italy

    Marco Borghesi & Riccardo Schiavina

  3. Department of Urology, University of Padua, Giustiniani 2 Street, 35128, Padua, Italy

    Giacomo Novara & Vincenzo Ficarra

Authors
  1. Marco Borghesi
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  2. Riccardo Schiavina
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  3. Melanie Gan
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  4. Giacomo Novara
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  5. Alexandre Mottrie
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  6. Vincenzo Ficarra
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Corresponding author

Correspondence to Marco Borghesi.

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Borghesi, M., Schiavina, R., Gan, M. et al. Expanding utilization of robotic partial nephrectomy for clinical T1b and complex T1a renal masses. World J Urol 31, 499–504 (2013). https://doi.org/10.1007/s00345-013-1095-2

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  • DOI: https://doi.org/10.1007/s00345-013-1095-2

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