1114 ROBOTIC PARTIAL NEPHRECTOMY VERSUS LAPAROSCOPIC CRYOABLATION FOR THE SMALL RENAL MASS

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You have accessJournal of UrologyKidney Cancer: Localized I1 Apr 20121114 ROBOTIC PARTIAL NEPHRECTOMY VERSUS LAPAROSCOPIC CRYOABLATION FOR THE SMALL RENAL MASS julien guillotreau, Jihad kaouk, Riccardo Autorino, Ranko Miocinovic, Shahab Hillyer, Adrian Hernandez, Humberto Laynder, Jean Alexandre long, Rachid yakoubi, wahib Isac, Robert Stein, and georges pascal Haber julien guillotreaujulien guillotreau Cleveland, OH More articles by this author , Jihad kaoukJihad kaouk Cleveland, OH More articles by this author , Riccardo AutorinoRiccardo Autorino Cleveland, OH More articles by this author , Ranko MiocinovicRanko Miocinovic Cleveland, OH More articles by this author , Shahab HillyerShahab Hillyer Cleveland, OH More articles by this author , Adrian HernandezAdrian Hernandez Cleveland, OH More articles by this author , Humberto LaynderHumberto Laynder Cleveland, OH More articles by this author , Jean Alexandre longJean Alexandre long Cleveland, OH More articles by this author , Rachid yakoubiRachid yakoubi Cleveland, OH More articles by this author , wahib Isacwahib Isac Cleveland, OH More articles by this author , Robert SteinRobert Stein Cleveland, OH More articles by this author , and georges pascal Habergeorges pascal Haber Cleveland, OH More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1222AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Partial Nephrectomy is the gold standard for treatment of small renal masses (SRMs). Laparoscopic cryoablation (LCA) has provided encouraging outcomes. Robotic partial nephrectomy (RPN) represents a new promising option, but is still under evaluation. Aim of this study was to compare outcomes of patients with (SRMs) treated with (RPN) and (LCA). METHODS From January 1998 to December 2010, 436 patients underwent minimally invasive nephron-sparing surgery (RPN or LCA) for SRMs (less than 4cm). Perioperative, oncological and functional outcomes were assessed. Comparative analysis was performed between RPN and LCA. RESULTS A total of 446 small renal masses were identified in 436 patients (RPN, n=210 and LCA, n=226). Patients undergoing RPN were younger (p<0.0001), had a lower ASA score (p<0.001), and higher baseline preoperative eGFR (p<0.0001). Mean tumor size was smaller in the LCA group (2.2 vs 2.4 cm; p=0.004). RPN was associated with longer operative time (180 vs 165min; p=0.01), increased estimated blood loss (200 vs 75ml; p<0.0001), longer hospital stay (72 vs 48hours; p<0.0001) and higher morbidity rate (21% vs 11%, p=0.005). Mean follow-up for RPN and LCA were 4.8 and 44.5 months (p<0.0001). Local recurrence rates for RPN and LCA were 0% and 11%, respectively (p<0.0001). Recurrence after LCA developed after a mean follow-up of 11.5 months (range 4.6-52.5). Mean eGFR decrease after RPN and LCA was insignificant at 1 month, 6 months after surgery and during last follow-up. CONCLUSIONS Despite a higher morbidity, RPN provides excellent mid-term functional and oncological outcomes compared to LCA. Both techniques remain viable options for management of small renal masses. However, LCA should be considered for patients with higher risk of complications. Long-term follow-up is needed to confirm our results. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e451-e452 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information julien guillotreau Cleveland, OH More articles by this author Jihad kaouk Cleveland, OH More articles by this author Riccardo Autorino Cleveland, OH More articles by this author Ranko Miocinovic Cleveland, OH More articles by this author Shahab Hillyer Cleveland, OH More articles by this author Adrian Hernandez Cleveland, OH More articles by this author Humberto Laynder Clev