title: Split renal function of both kidneys after robot-assisted partial nephrectomy for renal tumor larger than 4 cm.
abstract: OBJECTIVE
  Relative few studies reported the changes in split renal function using renal scintigraphy for robot-assisted partial nephrectomy (RaPN) for renal tumor >4 cm. This study aimed at demonstrating that RaPN is safe for renal tumor >4 cm without damaging the renal function of ipsilateral and contralateral kidney.
  
  
  METHODS
  Patients who underwent RaPN for single renal tumor from December 2009 to December 2013 were identified from a prospectively collected database. We compared demographic, perioperative, and postoperative outcomes between patients with renal tumor >4 cm (case group) and patients with renal tumor ≦4 cm (control group). Renal function was assessed by serum creatinine, estimated glomerular filtration rate, and effective renal plasma flow (ERPF).
  
  
  RESULTS
  One hundred and three consecutive patients (45 in case group and 58 in control group) were identified. Case group had significantly longer operative time (P = 0.011), longer warm ischemia time (P < 0.001), and more estimated blood loss (P = 0.010) than control group. Only one patient in the case group had conversion surgery. There was no significant difference regarding hospital stay, blood transfusion, complications rate, and positive surgical margin. The changes in ipsilateral ERPF and contralateral ERPF were not significantly different between groups (ipsilateral kidney: -10.5 vs. -12.5%, P = 0.989; contralateral kidney: -3.6 vs. -5.2%, P = 0.611).
  
  
  CONCLUSIONS
  RaPN is a safe and feasible modality of nephron-sparing surgery for renal tumor >4 cm, as it is for renal tumor ≦4 cm.
authors.affiliation: Department of Urology, Cheng-Hsin General Hospital, Taipei, Taiwan, ROC.|Department of Urology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei, 11217, Taiwan, ROC.|Department of Urology, School of Medicine and Shu-Tien Urological Research Institute, National Yang-Ming University, Taipei, Taiwan, ROC.
authors.forename: Sheng-Han
authors.initials: SH
authors.lastname: Tsai
authors.affiliation: Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.|Department of Radiology, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.
authors.forename: Yi-Chen
authors.initials: YC
authors.lastname: Lai
authors.affiliation: Institute of Biomedical Informatics, National Yang-Ming University, Taipei, Taiwan, ROC.
authors.forename: Nai-Yuan
authors.initials: NY
authors.lastname: Wu
authors.affiliation: Department of Urology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei, 11217, Taiwan, ROC. hjchung@vghtpe.gov.tw.|Department of Urology, School of Medicine and Shu-Tien Urological Research Institute, National Yang-Ming University, Taipei, Taiwan, ROC. hjchung@vghtpe.gov.tw.
authors.forename: Hsiao-Jen
authors.initials: HJ
authors.lastname: Chung
mesh_terms: D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D002292:Carcinoma, Renal Cell / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods; D009399:Nephrons / Q000473:pathology; D061646:Operative Time; D059351:Organ Sparing Treatments / Q000009:adverse effects / Q000379:methods; D010043:Outcome and Process Assessment, Health Care; D011183:Postoperative Complications / Q000175:diagnosis / Q000503:physiopathology / Q000517:prevention & control; D017596:Renal Plasma Flow, Effective; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000009:adverse effects / Q000379:methods; D013624:Taiwan; D047368:Tumor Burden; D052096:Warm Ischemia / Q000706:statistics & numerical data
keywords: Kidney function; Organ-sparing treatments; Robotic surgical procedures