title: Open versus robot-assisted partial nephrectomy: effect on clinical outcome.
abstract: OBJECTIVE
  Robot-assisted partial nephrectomy (RPN) has emerged as a viable alternative to open partial nephrectomy (OPN) for small renal masses (SRMs). Comparative outcomes of RPN and OPN at a single institution were analyzed.
  
  
  METHODS
  A retrospective review was performed to compare 69 RPNs with 234 OPNs between May 2003 and December 2010 at a single institution. Clinicopathologic variables, operative parameters, and renal functional outcomes were analyzed.
  
  
  RESULTS
  There were no significant differences between the two cohorts (RPN vs OPN) with respect to patient age (P=0.609), sex (P=0.703), preoperative estimated glomerular filtration rate (eGFR, P=0.146), estimated blood loss (P=0.600), and tumor size (P=0.256). The mean operative time was longer in the RPN group (192 vs 142 min, P<0.001). The mean warm ischemia time was longer in the RPN cohort (22.99 vs 18.87 min, P<0.001), but there were no significant differences in the postoperative eGFR (P=0.162) and change in the eGFR (P=0.520). The length of hospitalization (6.2 vs 8.9 d, P<0.001) and use of postoperative analgesics (ketoprofen, 0.26 vs 0.88 ampules, P<0.001) were more favorable in the RPN cohort. The number of patients with positive surgical margins was 0 for the RPN and 6 for the OPN groups. The intraoperative complication rates were 4.35% and 4.27% in the RPN and OPN groups, respectively (P=0.999). The overall postoperative complication rates were 8.7% and 15.4% in the RPN and OPN groups, respectively (P=0.158).
  
  
  CONCLUSIONS
  RPN is a viable option as a nephron-sparing surgical procedure for SRMs considering the perioperative parameters and postoperative renal function changes, in addition to the traditional benefits of the laparoscopic procedure.
authors.affiliation: Department of Urology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Sangchul
authors.initials: S
authors.lastname: Lee
authors.forename: Jongjin
authors.initials: J
authors.lastname: Oh
authors.forename: Seong Kyu
authors.initials: SK
authors.lastname: Hong
authors.forename: Sang Eun
authors.initials: SE
authors.lastname: Lee
authors.forename: Seok-Soo
authors.initials: SS
authors.lastname: Byun
mesh_terms: D005260:Female; D006801:Humans; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D012371:Robotics / Q000379:methods*; D016896:Treatment Outcome