Category: Laparoscopic/ Robotic: Other

MP30-22 - Comparison of oncological and perioperative outcomes of open, laparoscopic, and robotic nephroureterectomy approaches in patients with non-metastatic upper-tract urothelial carcinoma

Sun, Sep 23
2:00 PM - 4:00 PM

Introduction & Objective : We aimed to compare the actual oncological and perioperative outcomes of different nephroureterectomy approaches in patients with non-metastatic upper-tract urothelial carcinoma (UTUC).


Methods : We retrospectively analyzed the data of 422 patients who underwent open, laparoscopic, or robotic nephroureterectomy for non-metastatic UTUC. The peri- and postoperative survival outcomes were compared using Kaplan-Meier analyses and Cox-proportional hazard models.


Results : A total of 161, 137, and 124 patients were treated with an open, laparoscopic, or robotic approach, respectively. The laparoscopic and robotic approaches involved significantly less blood loss (p = 0.001), shorter hospital stay (p < 0.001), and longer operation time (p < 0.001) than the open approach. There were no significant differences in intraoperative complications (open, 8.1%; laparoscopy, 5.1%; robotic, 9.7%; p = 0.363) or early postoperative complications (open, 65.8%; laparoscopy, 73.7%; robotic, 75.0%; p = 0.170). The laparoscopic and robotic groups showed significantly less postoperative analgesic drug use (p = 0.015). The robotic group showed significantly longer progression-free, cancer-specific, and overall survival than the open approach in univariate Kaplan-Meier analysis, but surgery type did not show any significant association with any survival outcomes after multivariate Cox proportional tests (all p > 0.05). 


Conclusions :

The laparoscopic and robotic approaches involved better perioperative outcomes in terms of less intraoperative bleeding, shorter hospital stays, less analgesic usage, and non-inferior oncological outcomes than the open approach. Further prospective studies are needed to better compare these surgical techniques.

BeongDo Song

Resident
Seoul National University Bundang Hospital
Seoul, Seoul-t'ukpyolsi, 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

Sang Eun Lee

Seoul, Seoul-t'ukpyolsi, Republic of Korea

Sung Kyu Hong

Seoul, Seoul-t'ukpyolsi, Republic of Korea

Seok-Soo Byun

Seongnam, Kyonggi-do, Republic of Korea

BeongDo Song

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

BeongDo Song

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

BeongDo Song

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