Retroperitoneal robotic partial nephrectomy for T1b and larger tumours
BAUS ePoster online library. Segaran S. Jun 27, 2018; 211383; P9-11
Mr. Surayne Segaran
Mr. Surayne Segaran
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Abstract
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Objectives: To determine the operative outcomes of retroperitoneal robotic-assisted partial nephrectomy (RRAPN) for T1b and larger tumours.

Subjects and Methods: A prospective database of all renal surgery is kept at our institution which was examined retrospectively to obtain relevant data.

Results: 337 RAPN were performed between June 2010 - July 2017. 56 (17%) had tumours >40mm and 52 underwent RRAPN. 20 were female and 32 male. Mean age was 60 years (SD ± 12.7), mean BMI was 30 (SD ± 6.9), median ASA grade was 2 and mean tumour size was 50mm (SD ± 9.9). Operative time averaged 154 minutes (SD ± 37.8). Mean warm ischaemia time (WIT) was 24 minutes (SD ± 9.5). Median estimated blood loss (EBL) was 50ml (0-2000). 3.8% had positive margins.
2 procedures were converted to radical nephrectomy (robotic) and 1 each were converted to open partial nephrectomy and open radical nephrectomy. 4 patients received blood transfusions. 2 patients had Clavien-Dindo Grade 3 complications. Median postoperative length of stay (LOS) was 2 days (1-12).
Compared to patients undergoing RRAPN for T1a tumours, there were statistically significant differences in operative time (125 vs 154 mins, p<0.01), WIT (21 vs 24 mins, p=0.01), EBL (40 vs 200ml, p<0.01) but no difference in LOS. There was a lower positive margin rate of 1.4% in the T1a group.

Conclusion: RRAPN can be safely utilised for suitable T1b and larger renal tumours with few complications and rapid recovery. Resection of T1b tumours may be more challenging than T1a tumours.
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