Renal CancerOutcomes of Robotic Partial Nephrectomy for Renal Masses With Nephrometry Score of ≥7
Section snippets
Material and Methods
From February 2007 to June 2010, 164 patients had undergone RPN. The patient data were entered prospectively into our institutional review board-approved RPN database. Of the 164 patients, the films for 52 patients were not accessible either because of missing hard copies (returned to the patients) or an inability to access them from our electronic system. A total of 112 patients had computed tomography scans available for review, and 6 were excluded because of multiple masses in a single renal
Results
A total of 67 patients who had undergone RPN for moderately or highly complex renal masses were included in the present study. The median tumor size was 3.7 cm (range 1.2-11), with a median operative time of 180 minutes (range 150-180). The median EBL was 200 mL (range 100-375), and the WIT was 19 minutes (range 15-26). The median hospital stay was 3.0 days (range 3-4). The overall results are detailed in Table 3. A total of 15 complications occurred. These were graded using the Clavien-Dindo
Comment
Gettman et al20 were the first to report the use of the da Vinci surgical system (Intuitive Surgical) to assist in laparoscopic partial nephrectomy. They performed 13 procedures, and the mean size of the tumor resected was 3.5 cm, with a mean operative time of 215 minutes and a WIT of 22 minutes. The mean EBL was 170 mL, and the mean LOS was 4.3 days. At 2-11 months of follow-up, no recurrence had been noted.
Since then, >24 reports have been published on the technique and specific institutions'
Conclusions
RPN is safe and feasible for patients with moderate to highly complex renal masses, as defined by a score of ≥7 using the R.E.N.A.L. nephrometry score. The risk of adverse outcomes will be increased for patients with a nephrometry score of ≥10. Larger studies and long-term follow-up are needed to determine efficacy of renal function preservation and oncologic adequacy.
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G.-P. Haber is a speaker for Intuitive Surgical; R. J. Stein is a speaker for Applied Medical; and J. H. Kaouk is a speaker for Intuitive Surgical and Covidien.