Efficacy And Safety Of Robotic Partial Nephrectomy In The Management Of Cystic Renal Masses
BAUS ePoster online library. Brousil P. Jun 25, 2019; 259581; P8-5
Mr. Philip Brousil
Mr. Philip Brousil
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INTRODUCTION:Limited data is available on the outcomes of Robotic Partial Nephrectomy(RPN) for cystic tumours(CyT). The objective of this study is to compare the outcomes of RPN for CyT and solid tumours(ST), analysing the largest single-institutional,multi-surgeon database of RPN in the UK.
Renal masses were categorized as ST or CyT according to the analysis of cross-sectional imaging and histopathology gross description.
From 2010 to 2018, 314 RPN with full data on type of lesion were performed. Of those, 77.1%(242) were solid and 22.9%(72) were cystic. Both groups had similar baseline patient and tumour characteristics(Table 1).Warm ischemia time, operation length and blood loss were similar between groups. There were no positive margins in the CyT group and only 2.7% in the ST group(p=0.18).Intra and post-operative complication rates were similar between groups(16.9vs13.9%,p=0.92). The most common type of complication in both groups was infection. There was a single case of CyT rupture during specimen extraction that resulted in a recurrence in the rectus sheath. The overall recurrence rate was 1.2% and 1.4% in CyT and ST, respectively(p=0.92). At multivariate analysis a CyT was not an independent risk factor for recurrence, positive margin, complications or longer WIT.
CONCLUSION:RPN in CyT is a safe and effective procedure with similar trifecta outcomes when compared with the same procedure in solid masses, even when considering a more challenging population in terms of patient characteristics and higher tumour complexity.The increased risk of rupture during dissection or tumour excision makes RPN in CyT a complex procedure with several technical intricacies.
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