Laparoscopic/ Robotic: Other

Moderated Poster Session

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

Saturday, September 22
10:00 AM - 12:00 PM
Location: Room 243

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

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    Gabriele Tuderti

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

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      Andrea Mari

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        Andrea Minervini

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

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          Marco Carini

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            Manuela Costantini

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

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              Riccardo Bertolo

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

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

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                Francesco Porpiglia

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

                Full Professor of Urology at Department of Urology, Hospital San Luigi Gonzaga, University of Turin.

                His scientific interests ranges from the oncology to the minimally invasive surgical techniques, from the andrology to the diagnostic imaging of urological cancers.

                The majority of his papers were published on prestigious journals, in particular:
                • 43 on European Urology, the premier specialist journal in the field of Urology and Nephrology and the official journal of the European Association of Urology (EAU)
                • 25 on the British Journal of Urology (BJU) International
                • 18 on Minerva Urologica & Nefrologica (MUN)
                • 16 on Urology
                • 14 on the Journal of Urology
                • 11 on the World Journal of Urology (WJU)
                • 10 on the Journal of Endourology

                Research Interests.
                1. Laparoscopy.
                2. Robot-assisted surgery.
                3. Uro-oncology.
                4. Diagnostic Imaging.
                5. Endoscopy.
                6. Basic research.

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                  Koon Ho Rha

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                    Kidon Chang

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                      Luigi Schips

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                        Francesco Berardinelli

                        Urology Unit, Annunziata Hospital, Chieti, Italy

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                          Uzoma Anele

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                            James Porter

                            Medical Director for Robotic Surgery
                            Swedish Medical Center

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                              Robert Uzzo

                              Professor and Chief of Surgical Oncology
                              Fox Chase Cancer Center

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                                Alexander Kutikov

                                Fox Chase Cancer Center

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                                  Riccardo Autorino

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                                    Michele Gallucci

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                                      Giuseppe Simone

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

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