title: [Eight years of experience in robot-assisted partial nephrectomy: oncological and functional outcomes].
abstract: BACKGROUND
  Partial nephrectomy (PN) is currently the reference treatment for renal tumors of less than 4 cm in size (T1a). Laparoscopic PN is difficult to perform, with the main consequence being an increase in warm ischemia time and morbidity. In facilitating the surgical procedure, robotics combines the benefits of minimally invasive and conservative surgery. We report here 8 years of experience with 110 robot-assisted partial nephrectomies (RAPN). The objective of this study was to analyze the oncological and functional outcomes.
  
  
  METHODS
  Between March 2005 and September 2012, 110 patients underwent RAPN. The epidemiological and surgical data and the oncological and functional outcomes were retrospectively collected and analyzed.
  
  
  RESULTS
  Seventy-six men and 34 women underwent surgery. The mean age was 59.6 ± 14.2 years. Mean operative time was 141.3 ± 36.1 minutes with a warm ischemia time of 21.2 ± 8.8 minutes. Mean hospital stay was 5.3 ± 2.2 days. Mean tumor size was 27.4 ± 9.8mm with 82.7% malignant tumors, of which 62.7% were clear cell carcinomas. Surgical margins were healthy in 100% of cases. After a mean follow-up of 28.7 ± 18.5 months, no recurrence was noted. On a functional level, there was no short-term or medium-term impairment of renal function. The frequency of postoperative complications was estimated as 12% including 7% of surgical complications (3 arterial pseudoaneurysms, 4 episodes of bleeding from the cut surface and 1 conversion to laparotomy).
  
  
  CONCLUSIONS
  Robotics brought surgeon dexterity, meticulousness and precision. These qualities are essential in conservative renal surgery and made RAPN a safe and effective technique that gives good short and medium-term oncological and functional results.
authors.affiliation: Service d'urologie, CHU de Nancy, 1, rue du Morvan, 54500 Vandœuvre-les-Nancy, France. Electronic address: etiennebarbier1@gmail.com.
authors.forename: E
authors.initials: E
authors.lastname: Barbier
authors.affiliation: Service d'urologie, groupe hospitalier Paris-Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France.
authors.forename: P-E
authors.initials: PE
authors.lastname: Theveniaud
authors.affiliation: Service de radiologie, CHU de Nancy, rue du Morvan, 54500 Vandœuvre-les-Nancy, France.
authors.forename: M
authors.initials: M
authors.lastname: Claudon
authors.affiliation: Service d'urologie, CHU de Nancy, 1, rue du Morvan, 54500 Vandœuvre-les-Nancy, France.
authors.forename: P
authors.initials: P
authors.lastname: Eschwege
authors.affiliation: Service d'urologie, CHU de Nancy, 1, rue du Morvan, 54500 Vandœuvre-les-Nancy, France.
authors.forename: J
authors.initials: J
authors.lastname: Hubert
mesh_terms: D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D020127:Recovery of Function; D012189:Retrospective Studies; D012371:Robotics; D013997:Time Factors; D016896:Treatment Outcome
keywords: Chirurgie robot-assistée; Da Vinci; Laparoscopie; Laparoscopy; Nephron-sparing; Néphrectomie partielle; Partial nephrectomy; Renal tumor; Robot-assisted surgery; Tumeur rénale; Urologie; Urology; Épargne néphronique
vernacular_title: Huit ans d'expérience en néphrectomie partielle robot-assistée: résultats carcinologiques et fonctionnels.