Category: Laparoscopic/ Robotic: Other

MP16-15 - Perioperative outcomes of Cold Ischemia Partial nephrectomy: A Propensity Score Matched Analysis Comparing Robotic vs Open Approach

Sat, Sep 22
10:00 AM - 12:00 PM

Introduction & Objective :

Intracorporeal renal cooling is a common practice in open partial nephrectomy. We recently published a novel technique of intracorporeal ice kidney cooling technique during the robotic approach. The aim of this study was to compare cold ischemia technique performed with robot-assisted (RPN) or open partial nephrectomy (OPN).


Methods :

Consecutive patients undergoing partial nephrectomy using cold ischemia technique were extracted from our prospectively maintained database (2006-2016). RPN and OPN patients were 1:2 propensity-score (PS) matched via a greedy algorithm. The balance of the baseline variables was checked for the matched cohorts. 


Results :

51 RPN and 334 OPN using cold ischemia were extracted. After PS adjustments, there were no significant differences in baseline clinical features between the groups comparing 51 RPN and 102 OPN. Perioperative data comparison was reported in Table 1. Blood loss and hospital stay were significantly shorter in RPN. Complications were higher in OPN. Preservation of eGFR was significantly higher for RPN (81% vs 83%, cRPN vs cOPN, respectively, p=0.038), but no differences were found in the percentages of patients who experienced postoperative CKD upstaging (39% (38 patients) vs 44.7% (42 patients), cRPN vs cOPN, respectively, p = 0.494). 


Conclusions :

According to our institutional experience, during RPN the reproducibility of cold ischemia technique is at least non-inferior to that of OPN. Further studies are needed to confirm these results.

Juan Garisto

MD
Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
Cleveland, Ohio

Juan Garisto, MD is an Advanced Laparoscopy & Robotics clinical fellow at Cleveland Clinic, Cleveland, OH, United States under the mentorship of Dr. Jihad Kaouk. He completed a Society of Urologic Oncology fellowship at the University of Toronto and did his urology residency training at Complejo Hospitalario Dr. A.A.Madrid in Panama City, Panama.

His current research interest in single port surgery and multidisciplinary management of urologic malignancies, in particular kidney and bladder cancer.

Riccardo Bertolo

MD
Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
Turin, Piemonte, Italy

Riccardo Bertolo, MD
Research Fellow, Robotic Urology,
Cleveland Clinic, Cleveland, OH, USA
PhD Candidate, Bioengineering in Medical/Surgical Sciences
Turin Politechnic, Italy

Julien Dagenais

MD
Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
Cleveland, Ohio

Daniel Sagalovich

MD
Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
Cleveland, Ohio

Jose Agudelo

MD
Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
Cleveland, Ohio

Sherif Armanyous

MD
Cleveland Clinic Foundation
Cleveland, Ohio

Tianming Gao

PhD
Quantitiative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
Cleveland, Ohio

Sij Hemal

Urological surgery resident
Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
Cleveland, Ohio

Jihad Kaouk

Professor and Director, Center for Robotic and Image Guided Surgery Vice Chair, Surgical Innovations
Glickman Urologic Institute, Cleveland Clinic
Cleveland, Ohio

Jihad Kaouk, MD FACS

Dr. Jihad Kaouk is an American Board certified Urologist and Director, Center of Robotic and Image Guided Surgery at the Cleveland Clinic Glickman Urological Institute. He also serves as Professor of Surgery at the Cleveland Clinic Lerner College of Medicine, Vice Chair for Surgical Innovations and chair holder for the Zegarac-Pollock Endowed Chair in laparoscopic and robotic surgery.
In Innovations, he has performed several first ever done surgical procedures, including the first Robotic single port surgery through the belly button in 2008, the first completely transvaginal kidney removal in 2009, and the first robotic perineal prostatectomy in 2014 Dr. Kaouk holds 2 USA patents for medical devices used during partial nephrectomy and in robotic surgery.

Since 2005, Dr. Kaouk has served on committees at the national and local levels. From 2005-2008, he served in the American Urological Association’s Urologic Diagnostic and Therapeutic Imaging Task Force, from 2006-2010 he was on the Guidelines for the Management of small Renal Masses committee. Currently Dr Kaouk serves as Chairman elect on the AUA New Technology and Imaging committee, and is President Elect of (SURS) Society of Urologic Robotic Surgery. Dr Kaouk is associate editor of Urology journal.

Dr Kaouk have lectured in 130 scientific meetings, chaired 24 urologic meeting and performed live surgery in 18 medical centers worldwide. He authored 460 peer reviewed scientific publication, 26 book chapters and hundreds of scientific abstracts and surgical movies. Dr Kaouk received 32 honors and awards including Cleveland clinic innovator award twice, Teacher of the Year award, and EndoUrology 2017 Best Fellowship Program Director Award.

Presently, Dr Kaouk holds membership with the American Urological Association, the Endourological Society, Society of Urologic Oncology, Society of Robotic Surgery, and the Lebanese Order of Physicians. He is a fellow of the American college of Surgeons.