992 POST OPERATIVE MORBIDITY OF ROBOTIC VERSUS OPEN PARTIAL NEPHRECTOMY: THE IMPACT OF PREOPERATIVE TUMOR CHARACTERISTICS

Abstract

You have accessJournal of UrologyKidney Cancer: Localized II1 Apr 2010992 POST OPERATIVE MORBIDITY OF ROBOTIC VERSUS OPEN PARTIAL NEPHRECTOMY: THE IMPACT OF PREOPERATIVE TUMOR CHARACTERISTICS Tariq A. Khemees, Benjamin J. Yuh, Andrew Stacey, David S. Sharp, Ronney Abaza, Geoffrey N. Box, Robert R. Bahnson, and Ahmad Shabsigh Tariq A. KhemeesTariq A. Khemees More articles by this author , Benjamin J. YuhBenjamin J. Yuh More articles by this author , Andrew StaceyAndrew Stacey More articles by this author , David S. SharpDavid S. Sharp More articles by this author , Ronney AbazaRonney Abaza More articles by this author , Geoffrey N. BoxGeoffrey N. Box More articles by this author , Robert R. BahnsonRobert R. Bahnson More articles by this author , and Ahmad ShabsighAhmad Shabsigh More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1961AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Published literature indicates that laparoscopic partial nephrectomy (LPN) may have higher post operative complications compared to open partial nephrectomy (OPN). Robotic assisted partial nephrectomy (RPN) may offer a less morbid alternative. The impact of tumor characteristics on surgical decision making and post operative outcome is not known. The aim of this study is to compare robotic vs open partial nephrectomy and the impact of tumor characteristics on early post operative surgical complications. METHODS An independent review board approved the review of 133 consecutive partial nephrectomies. The data from these cases were entered into a retrospective complication database. Tumors characteristics were defined according to the R.E.N.A.L. Nephrometry Score (RNS). All complications within 30 days of surgery were defined and graded using the Clavien system. Univariate and multivariable logistic regression were used to evaluate variables associated with complications RESULTS 59 OPN and 74 RPN were compared. There was no difference in mean patient's age, median ASA score, BMI, preoperative GFR or past abdominal surgery. The median RNS was 7.04 for OPN and 5.73 for RPN (p<0.001). The median post operative length of stay was 3.2 days for OPN and 2.1 days for RPN (p=0.007), the estimate blood loss (EBL) was 351ml and 199ml respectively (p=0.005). OPN had longer ischemic time (28.9 minutes) compared to RPN (19.1minutes) (p<0.001). There was no difference in positive surgical margins, incidence of post operative complications (22.8% vs 24.7%) or grade of complications. There were no post operative deaths. The RNS did not correlate with age, ASA score, BMI, surgical technique, preoperative GFR, operative time or incidence of post operative complications, however, it did correlate with EBL (p<0.001) and ischemic time (p<0.001) CONCLUSIONS Robotic partial nephrectomy had shorter length of stay and lower blood loss compared to open partial nephrectomy with similar rates of positive surgical margins and early postoperative complications. Patients with higher RNS were more likely to undergo OPN. Higher RNS did not predict the incidence of post operative complications; however, it did correlate with increased blood loss and ischemic time. Columbus, OH© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e386 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.Metrics Author Information Tariq A. Khemees More articles by this author Benjamin J. Yuh More articles by this author Andrew Stacey More articles by this author David S. Sharp More articles by this author Ronney Abaza More articles by this author Geoffrey N. Box More articles by this author Robert R. Bahnson More articles by this author Ahmad Shabsigh More articles by this author Expand All Advertisement Advertisement PDF downloadLoadi