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Perioperative and long-term renal functional outcomes of robotic versus laparoscopic partial nephrectomy: a multicenter matched-pair comparison

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Abstract

Purpose

We compared perioperative and long-term renal functional outcomes of robot-assisted partial nephrectomy (RAPN) with laparoscopic partial nephrectomy (LPN) for small renal masses.

Materials and methods

A total of 1,032 patients were included for evaluation; propensity score matching was performed to adjust for potential baseline confounders, which resulted in 195 LPNs matched to 195 RAPNs. Patient characteristics including preoperative estimated glomerular filtration rate (eGFR) were investigated, and postoperative results were evaluated.

Results

No significant differences were found between the groups with regard to age, body mass index, sex distribution, preoperative eGFR, or tumor size. The mean follow-up period was 32.4 ± 21.1 months for LPN patients versus 31.1 ± 24.5 months for RAPN patients (p = 0.589). Operative time (p < 0.001) and warm ischemic time (p < 0.001) were significantly shorter in the RAPN group. No significant differences were observed in the overall change in eGFR (p = 0.768) or positive surgical margin rate (p = 0.653). A multivariate analysis showed that preoperative eGFR and hypertension significantly influenced the risk of stage 3 and 4 chronic kidney disease. A significant deterioration in renal function occurred 3 months after surgery. However, renal function increased gradually after the nadir eGFR was reached. The amount of renal functional recovery was higher in the RAPN group.

Conclusions

Operative parameters for RAPN appear to be less affected by tumor complexity. Functional outcomes of RAPN were superior to those of LPN. Renal function recovered continuously during the 60-month follow-up period after partial nephrectomy.

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Acknowledgments

The authors wish to acknowledge the financial support of the Catholic Medical Center Research Foundation made in the program year of 2012.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standard

This study was approved by the appropriate Institutional Review Board at our Hospital and performed according to the ethical standard laid down by the 1964 declaration of Helsinki and its later amendments.

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Authors and Affiliations

  1. Department of Urology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea

    Jeong Ho Kim, Yong Hyun Park & Sung Hoo Hong

  2. Department of Urology, College of Medicine, Chungbuk National University, Cheongju, Korea

    Yong June Kim

  3. Department of Urology, Korea University School of Medicine, Seoul, Korea

    Seok Ho Kang

  4. Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea

    Seok Soo Byun

  5. Department of Urology, Seoul National University Hospital, Seoul, Korea

    Cheol Kwak

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  1. Jeong Ho Kim
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  2. Yong Hyun Park
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Correspondence to Sung Hoo Hong.

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Kim, J.H., Park, Y.H., Kim, Y.J. et al. Perioperative and long-term renal functional outcomes of robotic versus laparoscopic partial nephrectomy: a multicenter matched-pair comparison. World J Urol 33, 1579–1584 (2015). https://doi.org/10.1007/s00345-015-1488-5

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  • DOI: https://doi.org/10.1007/s00345-015-1488-5

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