Category: Laparoscopic/ Robotic: Other

MP25-5 - Comparison of parenchymal volume loss assessed by CT volumetry and renal functional recovery between conventional and robot-assisted laparoscopic partial nephrectomy

Sun, Sep 23
10:00 AM - 12:00 PM

Introduction & Objective :

Objectives: To perform a comparative evaluation of the benefits of robot-assisted procedure in laparoscopic partial nephrectomy (LPN) with respect to the renal functional recovery and parenchymal volume loss by CT volumetry among patients with pT1a renal cell carcinoma who underwent conventional and robot-assisted laparoscopic partial nephrectomy (RALPN) in a single institution.


Methods :


Methods: We retrospectively reviewed 89 patients treated by partial nephrectomy. Of these patients, 50 and 39, respectively, underwent conventional LPN and RALPN between November 2003 and 2017. The renal parenchymal and tumor volumes were determined using the Synapse Vincent® volume image analyzer before surgery and at 6-months after surgery. The resected volume and the parenchymal volume loss were calculated. In addition, the relationship between the parenchymal volume loss and postoperatively estimated glomerular filtration rates (eGFRs) was retrospectively analyzed.


Results :
Results: No difference was noted in the baseline characteristics between the LPN and RALPN groups. The warm ischemia time (WIT) was significantly shorter in the RALPN group than in the LPN group (18.7 vs. 17.0 min, respectively; p < 0.001). The rates of selective clamping was significantly higher in the RALPN group than in the LPN group (2.0 vs. 33.3%, respectively; p < 0.001). The median decrease in eGFR on postoperative days 1, 7, 30, and 90 was significantly lower in the RALPN group than in the LPN group (24.6 vs. 7.1%, p < 0.001; 18.9 vs. 3.0%, p < 0.001; 11.1 vs. 3.7%, p < 0.001; and 15.1 vs. 7.4%, p = 0.020, respectively). The ratio of the parenchymal loss to tumor volume was significantly lower in the RALPN group than in the LPN group (3.36 vs. 2.26, respectively; p = 0.039). The median postoperative parenchymal volume was significantly greater in the RALPN group than in the LPN group (134.8 vs. 147.5 mL, respectively; p = 0.034).


Conclusions :


Conclusions: The shorter WIT and the frequent selective clamping as well as the lower parenchymal volume loss in the RALPN contributed to the improvement in the postoperative renal functions in both short and long terms, respectively.

Sohei Kanda

assistant
Akita University graduated School of Medicine
Akita City, Akita, Japan

Sohei kanda
MD, PhD
Speciality : laparoscopic surgery, urogenital cancer

Takamitsu Inoue

Akita City, Akita, Japan

Shiori Nakajima

Akita city, Akita, Japan

Taketoshi Nara

Assistant
Urology/Akita University School of Medicine
Akita City, Akita, Japan

Syuji Chiba

Akita city, Akita, Japan

Kazuyuki Numakura

Assistant Professor
Akita University Graduate School
Akita city, Akita, Japan

EDUCATION

2006 Ph. D. (Doctor of Medicine) in Urology
Department of Urology and Renal Transplant Surgery
Akita University School of Medicine, Akita, Japan

Current Research
-Analysis of genetic contribution to renal cell carcinoma

2001 M.D. Akita University School of Medicine, Akita, Japan

CAREER HISTORY

2018-present Assistant Professor, Department of Urology, Akita University Graduate School of Medicine
2012-2018 Lecturer, Department of Urology, Akita University Graduate School of Medicine
2009-2012 Assistant, Department of Urology, Akita University Graduate School of Medicine
2008-2009 The Head of Urological Department, Fujiwara Memorial Hospital
2007-2008 The Head of Urological Department, Yokote Municipal Hospital
2006-2007 The chief of Urological Department, Iwate Prefectual Isawa Hospital
2005-2006 Senior resident, Department of Urology, Toranomon Hospital
2001-2005 Resident/Senior Resident, Department of Urology, Akita University School of Medicine

LICENSURE

2001 Medical Doctor’s Licence, Japan (No. 422401)

Mitsuru Saito

Akita city, Akita, Japan

Shintaro Narita

Akita city, Akita, Japan

Tomonori Habuchi

Akita City, Akita, Japan