Abstract
Background
Partial nephrectomy (PN) is the standard treatment for localized renal tumors. Laparoscopic
PN (LPN) after selective embolization of tumor (LPNE) in a hybrid operating room has
been developed to make LPN easier and safer. The aim of this study was to compare
outcomes of LPNE and robot-assisted PN (RAPN).
Patients and Methods
All patients who underwent an LPNE at Angers University Hospital between May 2015
and April 2017, and a RAPN at Diaconesses Croix Saint Simon hospital between October
2014 and April 2017 were prospectively included. The functional outcomes were evaluated
using the change of estimated glomerular filtration rate (eGFR) at 1 month, and the
oncological outcomes were evaluated using the positive surgical margin (PSM) rate.
Results
Fifty-seven patients underwent LPNE and 48 underwent RAPN. There was no difference
between oncological and functional outcomes, with 2 PSM (4.4%) in the LPNE group and
4 PSM (10.3%) in the RAPN group (P = .32), and a mean change in eGFR at 1 month of −5.5% for LPNE and −8.3% for RAPN
(P = .17). The mean surgical time was shorter in the LPNE group (150 vs. 195 minutes;
P < .001), and mean estimated blood loss was less in the LPNE group (185 vs. 345 mL;
P = .04).
Conclusion
The short-term oncological and functional outcomes for LPNE were comparable with those
for RAPN. A longer follow-up and a larger cohort of patients would be necessary to
verify the benefits of LPNE, which appears to be a very interesting alternative to
RAPN.
Keywords
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Article info
Publication history
Published online: July 12, 2018
Accepted:
July 7,
2018
Received in revised form:
July 4,
2018
Received:
May 26,
2018
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
