Category: Laparoscopic/ Robotic: Other

MP16-13 - Robotic partial nephrectomy for benign lesions larger than 7 cm: feasibility and safety

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

Introduction & Objective :

The rate of benign lesions at pathologic examination after partial nephrectomy is around 25 %,  so that it is preferred to do a conservative treatment even for large renal mass when technically feasible. We reported perioperative, functional and survival outcomes  of robotic partial nephrectomy for benign lesions larger than 7 cm.


Methods :

From a prospective multicentric data base, out of 309 patients, 38  received robotic partial nephrectomy (RPN) for renal masses larger than 7 cm with benign features at pathologic examination. Perioperative results, complication rates and functional results were collected and reported.


Results :

From April 2011 to July 2017, 38 patients, 25 females and 13 males,  received RPN for lesions larger than 7 cm with benign histology. Median age was 54 years (IQR 43-65), median preoperative hemoglobin and eGFR were 13.5 g/dl (IQR 12.75-14.5) and 89 (IQR 77-99) ml/min respectively. Median lesion size was 82 ( IQR 75-100) mm.  RPN was performed clampless in 17 cases (44.7%) and median operative time was 145 (122.5-208) minutes. Median Ischemia time was 22 (IQR 15.5-25.75) minutes. Overall complication rate was 26.3%, while high grade complication rate was 7.8 %. Median postoperative hemoglobin and eGFR were 11 (IQR 9.4-11.8) g/dl  and  80 (IQR 67-90.1) ml/min, respectively. At a median follow up of 23 months no patient developed recurrences and overall survival was rate 100%; median eGFR was 82 (IQR 63.4-91) ml/min, with 3 patients (7.9%) developing new onset stage 3a chronic kidney disease.


Conclusions :

Large renal masses should not be considered imperative indications to radical nephrectomy. RPN proved to be a feasible and safe surgical option. The functional benefits of conservative treatment must be taken into account due to the expected long term survival of these patients.

Mariaconsiglia Ferriero

MD, PhD
"Regina Elena" National Cancer Institute, Dept. of Urology
Rome, Lazio, Italy

Gabriele Tuderti

Fellow
"Regina Elena" National Cancer Institute, Dept. of Urology
Roma, Lazio, Italy

Andrea Mari


Florence, Toscana, Italy

Andrea Minervini

Department of Urology, University of Florence, Careggi Hospital, Florence, Italy
Florence, Toscana, Italy

Marco Carini


Florence, Toscana, Italy

Manuela Costantini

"Regina Elena” National Cancer Institute, Dept. of Urology
Rome, Lazio, Italy

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

Francesco Porpiglia

Full Professor of Urology
Department of Urology, AOU San Luigi Gonzaga Orbassano – Turin; University of Turin
Orbassano, Piemonte, Italy

Koon Ho Rha


Seoul, Yanggang-do, North Korea

Kidon Chang


Seoul, Yanggang-do, North Korea

Luigi Schips


Chieti, Abruzzi, Italy

Francesco Berardinelli

Urology Unit, Annunziata Hospital, Chieti, Italy
Chieti, Abruzzi, Italy

Uzoma Anele


Richmond, Virginia

James Porter

Medical Director for Robotic Surgery
Swedish Medical Center
Seattle, Washington

Robert Uzzo

Professor and Chief of Surgical Oncology
Fox Chase Cancer Center
Philadelphia, Pennsylvania

Alexander Kutikov


Philadelphia, Pennsylvania

Riccardo Autorino


Richmond, Virginia

Michele Gallucci


Roma, Lazio, Italy

Giuseppe Simone

Consultant
“Regina Elena” National Cancer Institute, Dept. of Urology
Roma, Lazio, Italy