Sarah Norton, Cristian Albu, Silvu David, Nauman Nabi, Girish Nama, Muhammad Akram, Eva Browne, Subhasis K Giri
Background: To evaluate the relative advantages of robotically assisted partial nephrectomy (RPN), using a matched-pair analysis, with laparoscopic PN (LPN) and to describe a technique in a step by step approach.
Methods: Between July 2016 and October 2017, 25 patients had RPN for renal tumour; the outcomes were compared retrospectively with 25 matched patients who had LPN. Patients were matched for age, gender, American Society of Anesthesiologists score, tumour side, size and location. Outcomes measures included operative time, estimated blood loss, warm ischaemia time (WIT), serum Creatinine before and after surgery, length of hospital stay, transfusion rate, operative and 30-day complications. We describe our technique of RPN and LPN in video lecture format.
Results: There was no significant difference between the two cohorts with respect to patient age, ASA score, preoperative serum Creatinine or tumor size. Median operative time for RPN was 180 vs. 220 minutes for LPN (P<0.05). There was a significant difference with respect to median warm ischemia time (18 vs. 25 minutes, P<0.05) and median length of hospital stay (4 vs. 6 days). Two patients in the LPN group had a urine leak managed conservatively and two required blood transfusion.
Conclusions: RPN is more favourable than LPN in terms of shorter total operation time, warm ischemia time, length of hospital stay and complications rates.
