title: Evaluation of laparoscopic vs robotic partial nephrectomy using the margin, ischemia and complications score system: a retrospective single center analysis.
abstract: OBJECTIVE
  To evaluate differences between Laparoscopic Partial Nephrectomy (LPN) and Robot-Assisted Partial Nephrectomy (RAPN) using the Margin, Ischemia and Complications (MIC) score system and to evaluate factors related with MIC success.
  
  
  METHODS
  Single centre retrospective study on 258 LPN and 58 RAPN performed between January 2012 and January 2014. Success was defined when surgical margins was negative, Warm Ischemia Time (WIT) was ≤ 20 minutes and no major complications occurred. Mann-Whitney-U and Pearson χ2 correlation were used to compare LPN and RAPN. A matched pair comparison was also performed. Spearman correlation (Rho) was used to evaluate the relationship between clinical, intra and post-operative and pathological patients characteristics with MIC score. A binary regression analysis was also performed to evaluate independent factors associated with MIC success.
  
  
  RESULTS
  The MIC rate in LPN and RAPN was 55% and 65.5% respectively. No differences in clinical, intra and post-operative outcomes between groups were found. Clinical tumor size (p-value: &lt; 0.001; OR: 0.829; 95% CI: 0.697-0.987), PADUA score (p-value: &lt; 0.001; OR: 0.843; 95% CI: 0.740-0.960), PADUA risk groups (intermediate; p-value: &lt; 0.001; OR: 0.416; 95% CI: 0.238- 0.792; high: p-value: &lt; 0.001; OR: 0.356; 95% CI: 0.199- 0.636), WIT (p-value: &lt; 0.001; OR: 0.598; 95% CI: 0.530- 0.675) were independently associated with MIC. eGFR (&lt; 60 vs ≥ 60 ml/min per 1.73 m2: p-value: &lt; 0.001; OR: 3.356; 95% CI: 1.701-6.621) and Fuhrman nuclear grade (p-value: 0.014; OR: 1.798; 95% CI:1.129-2.865) were also independently associated with MIC.
  
  
  CONCLUSIONS
  MIC score system is a simple and useful tool to report and to compare different surgical approach.
authors.affiliation: Department of Urology, Chinese PLA General Hospital, Beijing, China; Department of Urology, San Bassiano Hospital, Bassano Del Grappa. stefano.ricciardulli@gmail.com.
authors.forename: Stefano
authors.initials: S
authors.lastname: Ricciardulli
authors.forename: Qiang
authors.initials: Q
authors.lastname: Ding
authors.forename: Xu
authors.initials: X
authors.lastname: Zhang
authors.forename: Hongzhao
authors.initials: H
authors.lastname: Li
authors.forename: Yuzhe
authors.initials: Y
authors.lastname: Tang
authors.forename: Guoqiang
authors.initials: G
authors.lastname: Yang
authors.forename: Xiyou
authors.initials: X
authors.lastname: Wang
authors.forename: Xin
authors.initials: X
authors.lastname: Ma
authors.forename: Alberto
authors.initials: A
authors.lastname: Breda
authors.forename: Antonio
authors.initials: A
authors.lastname: Celia
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical; D002292:Carcinoma, Renal Cell / Q000601:surgery; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D065287:Robotic Surgical Procedures / Q000295:instrumentation* / Q000379:methods; D016896:Treatment Outcome; D052096:Warm Ischemia