Abstract
Background
Open partial nephrectomy (OPN) has previously been considered the gold standard procedure for treatment of T1 localized renal tumors. After introduction of robot assisted partial nephrectomy (RAPN) as an alternative method to OPN, OPN was gradually abandoned at our department. The aim of the study was to retrospectively compare the results of patients treated with either OPN or RAPN for suspected renal carcinoma.
Methods
Patients who underwent either open or robotic assisted partial nephrectomy between January 1st 2010 and December 31st 2020 were retrospectively included in the study. Each tumor subjected to surgery was scored preoperatively by the RENAL nephrometry score. Complications within 30 days were assessed according to the Clavien-Dindo classification system.
Results
A total of 197 patients who underwent partial nephrectomy were identified; 75 were subjected to OPN and 122 were treated with RAPN. The two groups of patients were similar with respect to age (OPN: 63 years ± 11, RAPN: 62 years ± 10), gender (OPN: 71/29%, RAPN: 67/33%), body mass index (OPN: 28 ± 5, RAPN: 28 ± 5), and ASA score (OPN: 2.4 ± 0.6, RAPN: 2.2 ± 0.5). Nephrometry score was 6.6 ± 1.7 in the OPN group compared to 6.9 ± 1.7 in the RAPN group (p = 0.2). The operative time was significantly shorter in the OPN group (81 minutes) compared to the RAPN group (144.5 minutes, p < 0.001). Mean perioperative blood loss was 227 ± 162 ml in the OPN group compared to 189 ± 152 ml in the RAPN group (p = 0.1). Mean length of stay was 3 days in the RAPN group compared to 6 days in the OPN group (p < 0.001). Positive surgical margin rate was significantly higher in the OPN group (21.6%) compared to the RAPN group (4.2%, p < 0.001). Complications of any grade was present in 33.3% of patients in the OPN group compared to 30.1% in the RAPN group (p = 0.6).
Conclusions
The introduction of RAPN at our department resulted in shorter length of stay and fewer positive surgical margins, without increasing complications.