Robot‐assisted partial nephrectomy is associated with early recovery of renal function: Comparison of open, laparoscopic, and robot‐assisted partial nephrectomy using DTPA renal scintigraphy

Abstract

Abstract Objectives To compare the functional outcomes of open, laparoscopic, and robot‐assisted partial nephrectomy (OPN, LPN, and RAPN, respectively) using diethylene triamine penta‐acetic acid (DTPA). Methods We identified 610 patients who underwent partial nephrectomy for renal cell carcinoma (285 open partial nephrectomy [OPN], 96 laparoscopic partial nephrectomy [LPN], and 229 robot‐assisted partial nephrectomy [RAPN]) with preoperative and postoperative DTPA within 1 year. We excluded multiple renal masses and history of immunotherapy or chemotherapy. Predictive factors for glomerular filtration rate (GFR) reduction were assessed using multivariate linear regression. Results Postoperative complications and disease‐free survival were similar in the three groups. Within 1 postoperative year, OPN showed a significantly lower mean ipsilateral GFR than LPN and RAPN (28.9 versus 32.4 versus 32.7 mL/min/1.73 m 2 , respectively; P < 0.001). RAPN was associated with a significantly higher total GFR than OPN within 1 year (76.6 versus 71.2 mL/min/1.73 m 2 , respectively; P = 0.001). On multivariate analysis within 1 year, operation type (OPN versus RAPN: β = 2.82; 95% confidence interval, 1.17–4.48; P = 0.001) was significantly associated with GFR reduction. Conclusion There was no difference in postoperative complications and disease‐free survival among operation types. RAPN could help to promote earlier recovery of ipsilateral GFR than OPN.