Comparison of perioperative outcomes of robot-assisted partial nephrectomy and open partial nephrectomy in patients with a solitary kidney

Homayoun Zargar, Sam Bhayani, Mohamad E Allaf, Michael Stifelman, Craig Rogers, Jeffrey Larson, Mark W. Ball, Susan Marshall, Ramesh Kumar, Amr Fergany, Steven Campbell, Jihad Kaouk

Research output: Contribution to journalArticle

Abstract

Purpose: To compare the perioperative outcomes of robot-assisted partial nephrectomy (RAPN) with open partial nephrectomy (OPN) in solitary kidneys.

Methods: Records of 1542 consecutive RAPN performed in five high-volume centers (2007-2013) were reviewed for patients with solitary kidneys. Results were compared with solitary OPN cases performed during the same period. Cases were divided into simple (R.E.N.A.L. nephrometry score 4-8) and complex (R.E.N.A.L. 9-12) groups. Demographics, surgical, pathologic, and follow-up data were compared between OPN and RAPN in each group.

Results: 40 RAPN and 85 OPN cases were identified. For both tumor complexity groups, patients in each treatment modality were comparable. There were higher proportions of OPN cases in the complex group (61.2% vs 25%; P=0.001). For both complexity tumor groups, there was no statistical difference between the treatment modalities in overall intraoperative/postoperative complications, transfusion rate, and positive surgical margin (PSM) rates. Patients in the RAPN group had a shorter length of hospital stay. For the entire cohort, there was no difference in estimated glomerular filtration rate preservation beyond 1 month (OPN 80.51%, RAPN 81.29%). Limitations include retrospective, nonrandomized nature of the series and small number of cases in the RAPN groups.

Conclusions: In the solitary kidney, RAPN offers comparable perioperative and short-term functional outcomes for localized tumors with low R.E.N.A.L. score. For more complex tumors, our early experience suggests comparability, but these results were obtained in selected cases and future studies will need to validate these results.

Original languageEnglish (US)
Pages (from-to)1224-1230
Number of pages7
JournalJournal of Endourology
Volume28
Issue number10
DOIs
StatePublished - Oct 1 2014

Fingerprint

Nephrectomy
Kidney
Length of Stay
Neoplasms
Intraoperative Complications
Glomerular Filtration Rate
Demography

ASJC Scopus subject areas

  • Urology

Cite this

Comparison of perioperative outcomes of robot-assisted partial nephrectomy and open partial nephrectomy in patients with a solitary kidney. / Zargar, Homayoun; Bhayani, Sam; Allaf, Mohamad E; Stifelman, Michael; Rogers, Craig; Larson, Jeffrey; Ball, Mark W.; Marshall, Susan; Kumar, Ramesh; Fergany, Amr; Campbell, Steven; Kaouk, Jihad.

In: Journal of Endourology, Vol. 28, No. 10, 01.10.2014, p. 1224-1230.

Research output: Contribution to journalArticle

Zargar, H, Bhayani, S, Allaf, ME, Stifelman, M, Rogers, C, Larson, J, Ball, MW, Marshall, S, Kumar, R, Fergany, A, Campbell, S & Kaouk, J 2014, 'Comparison of perioperative outcomes of robot-assisted partial nephrectomy and open partial nephrectomy in patients with a solitary kidney', Journal of Endourology, vol. 28, no. 10, pp. 1224-1230. https://doi.org/10.1089/end.2014.0297
Zargar, Homayoun ; Bhayani, Sam ; Allaf, Mohamad E ; Stifelman, Michael ; Rogers, Craig ; Larson, Jeffrey ; Ball, Mark W. ; Marshall, Susan ; Kumar, Ramesh ; Fergany, Amr ; Campbell, Steven ; Kaouk, Jihad. / Comparison of perioperative outcomes of robot-assisted partial nephrectomy and open partial nephrectomy in patients with a solitary kidney. In: Journal of Endourology. 2014 ; Vol. 28, No. 10. pp. 1224-1230.
@article{a32599138c88472cb02def1f74fad09a,
title = "Comparison of perioperative outcomes of robot-assisted partial nephrectomy and open partial nephrectomy in patients with a solitary kidney",
abstract = "Purpose: To compare the perioperative outcomes of robot-assisted partial nephrectomy (RAPN) with open partial nephrectomy (OPN) in solitary kidneys.Methods: Records of 1542 consecutive RAPN performed in five high-volume centers (2007-2013) were reviewed for patients with solitary kidneys. Results were compared with solitary OPN cases performed during the same period. Cases were divided into simple (R.E.N.A.L. nephrometry score 4-8) and complex (R.E.N.A.L. 9-12) groups. Demographics, surgical, pathologic, and follow-up data were compared between OPN and RAPN in each group.Results: 40 RAPN and 85 OPN cases were identified. For both tumor complexity groups, patients in each treatment modality were comparable. There were higher proportions of OPN cases in the complex group (61.2{\%} vs 25{\%}; P=0.001). For both complexity tumor groups, there was no statistical difference between the treatment modalities in overall intraoperative/postoperative complications, transfusion rate, and positive surgical margin (PSM) rates. Patients in the RAPN group had a shorter length of hospital stay. For the entire cohort, there was no difference in estimated glomerular filtration rate preservation beyond 1 month (OPN 80.51{\%}, RAPN 81.29{\%}). Limitations include retrospective, nonrandomized nature of the series and small number of cases in the RAPN groups.Conclusions: In the solitary kidney, RAPN offers comparable perioperative and short-term functional outcomes for localized tumors with low R.E.N.A.L. score. For more complex tumors, our early experience suggests comparability, but these results were obtained in selected cases and future studies will need to validate these results.",
author = "Homayoun Zargar and Sam Bhayani and Allaf, {Mohamad E} and Michael Stifelman and Craig Rogers and Jeffrey Larson and Ball, {Mark W.} and Susan Marshall and Ramesh Kumar and Amr Fergany and Steven Campbell and Jihad Kaouk",
year = "2014",
month = "10",
day = "1",
doi = "10.1089/end.2014.0297",
language = "English (US)",
volume = "28",
pages = "1224--1230",
journal = "Journal of Endourology",
issn = "0892-7790",
publisher = "Mary Ann Liebert Inc.",
number = "10",

}

TY - JOUR

T1 - Comparison of perioperative outcomes of robot-assisted partial nephrectomy and open partial nephrectomy in patients with a solitary kidney

AU - Zargar, Homayoun

AU - Bhayani, Sam

AU - Allaf, Mohamad E

AU - Stifelman, Michael

AU - Rogers, Craig

AU - Larson, Jeffrey

AU - Ball, Mark W.

AU - Marshall, Susan

AU - Kumar, Ramesh

AU - Fergany, Amr

AU - Campbell, Steven

AU - Kaouk, Jihad

PY - 2014/10/1

Y1 - 2014/10/1

N2 - Purpose: To compare the perioperative outcomes of robot-assisted partial nephrectomy (RAPN) with open partial nephrectomy (OPN) in solitary kidneys.Methods: Records of 1542 consecutive RAPN performed in five high-volume centers (2007-2013) were reviewed for patients with solitary kidneys. Results were compared with solitary OPN cases performed during the same period. Cases were divided into simple (R.E.N.A.L. nephrometry score 4-8) and complex (R.E.N.A.L. 9-12) groups. Demographics, surgical, pathologic, and follow-up data were compared between OPN and RAPN in each group.Results: 40 RAPN and 85 OPN cases were identified. For both tumor complexity groups, patients in each treatment modality were comparable. There were higher proportions of OPN cases in the complex group (61.2% vs 25%; P=0.001). For both complexity tumor groups, there was no statistical difference between the treatment modalities in overall intraoperative/postoperative complications, transfusion rate, and positive surgical margin (PSM) rates. Patients in the RAPN group had a shorter length of hospital stay. For the entire cohort, there was no difference in estimated glomerular filtration rate preservation beyond 1 month (OPN 80.51%, RAPN 81.29%). Limitations include retrospective, nonrandomized nature of the series and small number of cases in the RAPN groups.Conclusions: In the solitary kidney, RAPN offers comparable perioperative and short-term functional outcomes for localized tumors with low R.E.N.A.L. score. For more complex tumors, our early experience suggests comparability, but these results were obtained in selected cases and future studies will need to validate these results.

AB - Purpose: To compare the perioperative outcomes of robot-assisted partial nephrectomy (RAPN) with open partial nephrectomy (OPN) in solitary kidneys.Methods: Records of 1542 consecutive RAPN performed in five high-volume centers (2007-2013) were reviewed for patients with solitary kidneys. Results were compared with solitary OPN cases performed during the same period. Cases were divided into simple (R.E.N.A.L. nephrometry score 4-8) and complex (R.E.N.A.L. 9-12) groups. Demographics, surgical, pathologic, and follow-up data were compared between OPN and RAPN in each group.Results: 40 RAPN and 85 OPN cases were identified. For both tumor complexity groups, patients in each treatment modality were comparable. There were higher proportions of OPN cases in the complex group (61.2% vs 25%; P=0.001). For both complexity tumor groups, there was no statistical difference between the treatment modalities in overall intraoperative/postoperative complications, transfusion rate, and positive surgical margin (PSM) rates. Patients in the RAPN group had a shorter length of hospital stay. For the entire cohort, there was no difference in estimated glomerular filtration rate preservation beyond 1 month (OPN 80.51%, RAPN 81.29%). Limitations include retrospective, nonrandomized nature of the series and small number of cases in the RAPN groups.Conclusions: In the solitary kidney, RAPN offers comparable perioperative and short-term functional outcomes for localized tumors with low R.E.N.A.L. score. For more complex tumors, our early experience suggests comparability, but these results were obtained in selected cases and future studies will need to validate these results.

UR - http://www.scopus.com/inward/record.url?scp=84912027366&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84912027366&partnerID=8YFLogxK

U2 - 10.1089/end.2014.0297

DO - 10.1089/end.2014.0297

M3 - Article

C2 - 24959704

AN - SCOPUS:84912027366

VL - 28

SP - 1224

EP - 1230

JO - Journal of Endourology

JF - Journal of Endourology

SN - 0892-7790

IS - 10

ER -