title: Robotic partial nephrectomy for clinical stage T1 tumors: Experience in 42 cases.
abstract: The aim of this study was to evaluate outcomes of robotic partial nephrectomy (RAPN) procedures. At two centers, 42 patients underwent RAPN. Radius, Exo/Endophytic, Nearness, Anterior/Posterior, Location (R.E.N.A.L.) nephrometry and PADUA scores of patients were calculated by computed tomography (CT) or magnetic resonance imaging (MRI). Intra- and perioperative (0-30 days) complications were evaluated using modified Clavien classification. A four-arm da Vinci-S robotic surgical system was used and outcomes were evaluated retrospectively. Mean age of the patients was 52.3 ± 6.5 years. Mean tumor size was 3.1 ± 1.0 (1.4-6.6) cm. R.E.N.A.L. nephrometry and PADUA scores were 6.0 ± 1.5 and 7.5 ± 0.9, respectively. Mean surgical time was 127.7 ± 18.7 minutes and estimated blood loss was 100 ± 18.1 cc. Mean warm ischemia time was 16.0 ± 8.9 (0-30) minutes. Intraoperative complications did not develop in any patient. Median hospital stay was 3.0 (2-6) days. Except for 17 patients, hilar clamping was performed in 25 patients. Histopathology results included 34 renal cell carcinoma (22 clear cell, 7 chromophobe cell, 4 papillary cell, and 1 clear papillary cell). Oncocytoma (n = 4), adenoma (n = 1), fibroadipose tissue (n = 1), papillary epithelial hyperplasia (n = 1), and chronic pyelonephritis (n = 1) were present. Surgical margins were negative in all patients. During a median follow-up period of 15.5 ± 10.9 (3-46) months, neither local recurrence nor distant metastasis was detected. In conclusion, RAPN is a safe, minimally invasive surgical approach, with excellent surgical and oncological outcomes in T1 kidney tumors. Zero ischemia off-clamp RAPN is also safe in selected masses with the advantage of avoiding complete renal ischemia.
authors: Department of Urology, Ankara Ataturk Training and Research Hospital, Ankara, Turkey. Electronic address: kemalener75@yahoo.com.
authors: Kemal
authors: K
authors: Ener
authors: Department of Urology, School of Medicine, Yildirim Beyazit University, Ankara Ataturk Training and Research Hospital, Ankara, Turkey.
authors: Abdullah Erdem
authors: AE
authors: Canda
authors: Department of Urology, Ankara Ataturk Training and Research Hospital, Ankara, Turkey.
authors: Serkan
authors: S
authors: Altinova
authors: Department of Urology, School of Medicine, Yildirim Beyazit University, Ankara Ataturk Training and Research Hospital, Ankara, Turkey.
authors: Ali Fuat
authors: AF
authors: Atmaca
authors: Department of Urology, Memorial Sisli Hospital, Istanbul, Turkey.
authors: Erdal
authors: E
authors: Alkan
authors: Department of Urology, Ankara Ataturk Training and Research Hospital, Ankara, Turkey.
authors: Erem
authors: E
authors: Asil
authors: Department of Urology, Ankara Ataturk Training and Research Hospital, Ankara, Turkey.
authors: Muhammet Fuat
authors: MF
authors: Ozcan
authors: Department of Urology, School of Medicine, Yildirim Beyazit University, Ankara Ataturk Training and Research Hospital, Ankara, Turkey.
authors: Ziya
authors: Z
authors: Akbulut
authors: Department of Urology, Memorial Sisli Hospital, Istanbul, Turkey.
authors: Mevlana Derya
authors: MD
authors: Balbay
mesh_terms: D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009392:Nephrectomy / Q000379:methods; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures; D016896:Treatment Outcome
keywords: Partial nephrectomy; Renal cell carcinoma; Robotics