Category: Laparoscopic/ Robotic: Other

MP16-21 - ‘Trifecta’ outcomes of robot-assisted partial nephrectomy in clinical T1b and T2 renal tumors

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

Introduction & Objective :

To analyze the outcomes of robot-assisted partial nephrectomy (RAPN) in patients with clinical T1b (cT1b) and T2 (cT2) renal tumors.


Methods :

We analyzed clinical data of 167 consecutive patients who underwent RAPN with a diagnosis of cT1b (n=154) and cT2 (n=13) between 2008 and 2017. A ‘trifecta’ of outcomes was assessed, with trifecta defined as a warm ischaemia time (WIT) of ≤ 25min, negative surgical margins, and no complications intraoperatively or within 3 months of RAPN. Perioperative outcomes were compared, and predictors of ‘trifecta’ achievement were assessed using multivariate logistic regression analysis.


Results :

For the entire cohort, the mean (standard deviation [SD]) operative time and estimated blood loss was 172.7 (71.0) min and 208.3 (222.0) mL, respectively. The mean (SD) WIT was 30.0 (9.4) min. The overall intraoperative and postoperative complication rate was 4.8% and 3.6%, respectively. There was no positive surgical margin (0%). Trifecta outcomes were achieved in 40 of 167 patients (24.0%). Maximal pathologic tumor size and ‘N’ component of R.E.N.A.L nephrometry score were found to be predictors of ‘trifecta’ achievement in multivariate analysis (Table 1).


Conclusions :

Our findings suggest that RAPN is a safe and feasible treatment option for cT1b and cT2 renal tumors. Maximal pathologic tumor size and nearness to collecting system (or renal sinus) were significant predictors for the ‘trifecta’ achievement.

Jung Kwon Kim

Clinical Fellow
Seoul National University Bundang Hospital
Seongnam, Kyonggi-do, Republic of Korea

Byung Do Song

Seongnam, Kyonggi-do, Republic of Korea

Hakmin Lee

Urologist
Seoul National University Bundang Hospital
Seoul, Seoul-t'ukpyolsi, Republic of Korea

Hakmin Lee

Department of Urology
Seoul National University Bundang Hospital

Jong Jin Oh

Seongnam, Kyonggi-do, Republic of Korea

Sangchul Lee

Seongnam, Kyonggi-do, Republic of Korea

Sung Kyu Hong

Seongnam, Kyonggi-do, Republic of Korea

Sang Eun Lee

Seoul, Seoul-t'ukpyolsi, Republic of Korea

Seok-Soo Byun

Seongnam, Kyonggi-do, Republic of Korea