Retroperitoneal robot - assisted partial nephrectomy: A single institution experience.
BAUS ePoster online library. Varma R. Jun 25, 2019; 259580; P8-4
Mr. Raghav Varma
Mr. Raghav Varma
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Abstract
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Introduction:
Traditionally, robot-assisted partial nephrectomy (RAPN) is performed via the transperitoneal approach. Few institutions have reported on outcomes and safety of retroperitoneal robot-assisted partial nephrectomy (R-RAPN). Most of these studies had small number of patients. To best to our knowledge, we are representing surgical outcomes of the world's largest single institution reported study on R-RAPN.

Methods:

Between 2012 and 2018, 442 patients underwent RAPN, of whom 397 patients had R-RAPN. We reviewed patients' demographic, operative data, postoperative complications and histology.

Results:

The median age was 60 years. The mean BMI was 28.5 kg/m² . Median maximum tumour diameter was 3.0 cm (IQR 2.0 - 3.7). The median R.E.N.A.L nephrometry score was 6. Almost half of excised tumours were located posteriorly. Median operative time and warm ischaemia time (WIT) were 129 min (IQR 105.6 - 150) and 21 min respectively. Median estimated blood loss is 20 mL. The median length of stay was 1 day. The rate of blood transfusion and postoperative complications were 1% and 4.5% respectively.

55% of tumours were reported as clear cell carcinomas (table 1). 80% of tumours were histologically staged as T1a with six positive margins (1.8%). There are only 3 reported recurrences (0.7%) with median follow-up of 35 months. Trifecta  (negative surgical margin, no postoperative complications, WIT ≤ 25 minutes) was achieved in 67.3%.

Conclusion:
R-RAPN represents a valid and safe approach to treat patients with posterior and most anterior small renal masses. R-RAPN achieves the required trifecta and a very short LOS.
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