Correspondence: Alexandre Mottrie M.D., Ph.D., Department of Urology, Onze-Lieve-Vrouw Ziekenhuis, Moorselbaan 164, 9300 Aalst, Belgium. Email: [email protected]Search for more papers by this author

Alexander Heinze,

Alexander Heinze

Department of Urology, OLV Ziekenhuis, Aalst, Belgium

School of Medicine, Universidad Nacional Autónoma de México, Mexico City, Mexico

Search for more papers by this author

Alessandro Larcher,

Alessandro Larcher

Department of Urology, OLV Ziekenhuis, Aalst, Belgium

Division of Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy

Search for more papers by this author

Paolo Umari,

Paolo Umari

Department of Urology, OLV Ziekenhuis, Aalst, Belgium

Department of Urology, Ospedali riuniti di Trieste, University of Trieste, Trieste, Italy

Search for more papers by this author

Nicola Fossati,

Nicola Fossati

Department of Urology, OLV Ziekenhuis, Aalst, Belgium

Division of Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy

Search for more papers by this author

Joey Piccolo,

Joey Piccolo

American British Cowdray Medical Center, Mexico City, Mexico

Search for more papers by this author

Ruben De Groote,

Ruben De Groote

Department of Urology, OLV Ziekenhuis, Aalst, Belgium

Search for more papers by this author

Marijn Goossens,

Marijn Goossens

Department of Urology, OLV Ziekenhuis, Aalst, Belgium

Search for more papers by this author

Vincent De Coninck,

Vincent De Coninck

Department of Urology, OLV Ziekenhuis, Aalst, Belgium

Search for more papers by this author

Geert De Naeyer,

Geert De Naeyer

Department of Urology, OLV Ziekenhuis, Aalst, Belgium

Search for more papers by this author

Alexandre Mottrie,

Corresponding Author

Alexandre Mottrie

[email protected]

Department of Urology, OLV Ziekenhuis, Aalst, Belgium

First published: 21 August 2018

https://doi.org/10.1111/iju.13754

Citations: 7

Share a link

Email
Wechat
Bluesky

Abstract

Objective

To determine the impact of imperative or elective indications on the perioperative, functional and oncological outcomes of patients undergoing robot-assisted partial nephrectomy.

Methods

Between June 2006 and September 2016, data of patients who underwent robot-assisted partial nephrectomy at the Onze-Lieve-Vrouwziekenhuis Hospital in Aalst, Belgium, were retrospectively reviewed from a prospectively collected database. Only patients with non-metastatic, clinical T1–T2 graded tumors were included. Perioperative, functional and oncological outcomes were recollected. A comparative analysis was carried out after dividing patients into two groups: those who underwent robot-assisted partial nephrectomy for an elective indication (group 1, n = 194), and for an imperative indication (group 2, n = 57) caused by a solitary kidney (n = 20), impaired renal function (n = 2) or both (n = 35).

Results

Patients in group 2 were older (74 vs 71 years, P < 0.001), and had a higher Charlson Comorbidity Index (P < 0.001) and American Society of Anesthesiologists score (P < 0.001). No differences were observed concerning laterality, sex, preoperative aspects and dimensions used for an anatomical score or clinical stage. Surgical outcomes considering estimated blood loss, surgical time, ischemia time and transfusion rate showed no significant difference between groups. The complication rate according to Clavien–Dindo showed no difference between groups (P = 0.6). No difference was found between groups with regard to percentage decrease of estimated glomerular filtration rate (7.4 vs 4.8%, P < 0.15).

Conclusions

Robot-assisted partial nephrectomy can be safely and effectively carried out by experienced surgeons in a high-volume center with similar perioperative, functional and oncological outcomes for both elective or imperative indications.

Conflict of interest

None declared.

References

1Campbell SC, Novick AC, Belldegrun A et al. Guideline for management of the clinical T1 renal mass. J. Urol. 2009; 182: 1271–9.
10.1016/j.juro.2009.07.004
PubMed Web of Science® Google Scholar
2Ljungberg B, Albiges L, Bensalah K et al. EAU guidelines on renal cell carcinoma. 2017. Available from URL: https://uroweb.org/wp-content/uploads/10-Renal-Cell-Carcinoma_2017_web.pdf
Google Scholar
3Takagi T, Kondo T, Omae K et al. Comparison of progression to end-stage renal disease requiring dialysis after partial or radical nephrectomy for renal cell carcinoma in patients with severe chronic kidney disease. Int. Urol. Nephrol. 2016; 48: 1421–7.
10.1007/s11255-016-1317-9
PubMed Web of Science® Google Scholar
4Lesage K, Joniau S, Fransis K, Van Poppel H. Comparison between open partial and radical nephrectomy for renal tumours: perioperative outcome and health-related quality of life. Eur. Urol. 2007; 51: 614–20.
10.1016/j.eururo.2006.10.040
PubMed Web of Science® Google Scholar
5Go AS, Chertow GM, Fan D, Mcculloch CE, Hsu C. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. Mortality 2004; 2006: 1296–305.
Google Scholar
6Kural AR, Demirkesen O, Onal B et al. Outcome of nephron-sparing surgery: Elective versus imperative indications. Urol. Int. 2003; 71: 190–6.
10.1159/000071845
PubMed Web of Science® Google Scholar
7Ahmed K, Khan R, Mottrie A et al. Development of a standardised training curriculum for robotic surgery: a consensus statement from an international multidisciplinary group of experts. BJU Int. 2015; 116: 93–101.
10.1111/bju.12974
PubMed Web of Science® Google Scholar
8Novara G, La Falce S, Kungulli A, Gandaglia G, Ficarra V, Mottrie A. Robot-assisted partial nephrectomy. Int. J. Surg. 2016; 36: 554–9.
10.1016/j.ijsu.2016.05.073
PubMed Web of Science® Google Scholar
9Levey AS, Stevens LA, Schmid CH et al. A new equation to estimate glomerular filtration rate. Ann. Intern. Med. 2009; 150: 604–12.
10.7326/0003-4819-150-9-200905050-00006
PubMed Web of Science® Google Scholar
10Thomas R, Kanso A, Sedor JR. Chronic kidney disease and its complications. Prim. Care 2008; 35: 329–44.
10.1016/j.pop.2008.01.008
PubMed Web of Science® Google Scholar
11Ficarra V, Novara G, Secco S et al. Preoperative aspects and dimensions used for an anatomical (PADUA) classification of renal tumours in patients who are candidates for nephron-sparing surgery. Eur. Urol. 2009; 56: 786–93.
10.1016/j.eururo.2009.07.040
PubMed Web of Science® Google Scholar
12Moch H, Cubilla AL, Humphrey PA, Reuter VE, Ulbright TM. The 2016 WHO classification of tumours of the urinary system and male genital organs—part a: renal, penile, and testicular tumours. Eur. Urol. 2016; 70: 93–105.
10.1016/j.eururo.2016.02.029
PubMed Web of Science® Google Scholar
13Clavien PA, Barkun J, de Oliveira ML et al. The Clavien-Dindo classification of surgical complications. Ann. Surg. 2009; 250: 187–96.
10.1097/SLA.0b013e3181b13ca2
PubMed Web of Science® Google Scholar
14Saklad M. Grading of patients for surgical procedures. J. Am. Soc. Anesthesiol. 1941; 2: 281–4.
10.1097/00000542-194105000-00004
Google Scholar
15Long JA, Lee B, Eyraud R et al. Robotic partial nephrectomy: imperative Vs elective indications. Urology 2012; 80: 833–7.
10.1016/j.urology.2012.06.045
PubMed Web of Science® Google Scholar
16Guillotreau J, Yakoubi R, Long JA et al. Robotic partial nephrectomy for small renal masses in patients with pre-existing chronic kidney disease. Urology 2012; 80: 845–51.
10.1016/j.urology.2012.05.038
PubMed Web of Science® Google Scholar
17Ficarra V, Minervini A, Antonelli A et al. A multicentre matched-pair analysis comparing robot-assisted versus open partial nephrectomy. BJU Int. 2014; 113: 936–41.
10.1111/bju.12570
CAS PubMed Web of Science® Google Scholar
18Volpe A, Ahmed K, Dasgupta P et al. Pilot validation study of the European Association of Urology robotic training curriculum. Eur. Urol. 2015; 68: 292–9.
10.1016/j.eururo.2014.10.025
PubMed Web of Science® Google Scholar
19Mariusdottir E, Jonsson E, Marteinsson VT, Sigurdsson MI, Gudbjartsson T. Kidney function following partial or radical nephrectomy for renal cell carcinoma: a population-based study. Scand J. Urol. 2013; 47: 476–82.
10.3109/21681805.2013.783624
PubMed Web of Science® Google Scholar
20Arora S, Abaza R, Adshead JM et al. “Trifecta” outcomes of robot-assisted partial nephrectomy in solitary kidney: a Vattikuti Collective Quality Initiative (VCQI) database analysis. BJU Int. 2018; 121: 119–23.
10.1111/bju.13967
CAS PubMed Web of Science® Google Scholar
21Larcher A, Capitanio U, De Naeyer G et al. Is robot-assisted surgery contraindicated in the case of partial nephrectomy for complex tumours or relevant comorbidities? A comparative analysis of morbidity, renal function, and oncologic outcomes. Eur. Urol. Oncol. 2018; 1: 61–8.
10.1016/j.euo.2018.01.001
PubMed Web of Science® Google Scholar

Citing Literature

Volume25, Issue9

September 2018

Pages 826-831

Assessing perioperative, functional and oncological outcomes of patients with imperative versus elective indications for robot-assisted partial nephrectomy: Results from a high-volume center

Correction(s) for this article

Corrigendum

Abstract

Objective

Methods

Results

Conclusions

Conflict of interest

References

Citing Literature

References

Information

About Wiley Online Library

Help & Support

Opportunities

Connect with Wiley

Assessing perioperative, functional and oncological outcomes of patients with imperative versus elective indications for robot-assisted partial nephrectomy: Results from a high-volume center

Correction(s) for this article

Corrigendum

Abstract

Objective

Methods

Results

Conclusions

Conflict of interest

References

Citing Literature

References

Related

Information