Robotic Partial Nephrectomy has better results compared with Open and Laparoscopic Surgery

18.07.2018

According to a new systematic review and meta-analysis, Robotic partial nephrectomy (RPN) results in most superior outcomes than either open (OPN) or laparoscopic partial nephrectomy (LPN).

Compared with OPN, RPN was associated with significantly less blood loss; fewer transfusions, complications, and readmissions; and shorter hospital stay.

Patients who underwent RPN also had less of a decline in estimated glomerular filtration rate (eGFR), lower recurrence rates, and improved survival. OPN, however, was associated with shorter operative and warm ischemia times than RPN.

Compared with LPN, RPN proved superior with shorter warm ischemia times, lower conversion rates, and fewer intraoperative and postoperative complications. Robotic surgery was also associated with fewer positive margins, less decline in eGFR, and better overall mortality. Results held even when investigators analyzed only complex renal mass cases.

The team further reported that hilar control techniques, selective and unclamped, are effective alternatives to clamped RPN.

The systematic review and meta-analysis focused on 98 comparative studies involving 20,282 patients.

Based on the contemporary literature, this comprehensive meta-analysis indicates that robotic partial nephrectomy delivers mostly superior, and at a minimum equivalent, outcomes compared to open and laparoscopic partial nephrectomy. Robotics has now matured into an excellent approach for performing partial nephrectomy for small renal masses.

Reference:

Cacciamani GE, Medina LG, Gill T, et al. Impact of surgical factors on robotic partial nephrectomy outcomes: comprehensive systematic review and meta-analysis. J Urol. 2018;200(2):258-274.