Robot-assisted partial nephrectomy versus laparoscopic partial nephrectomy: A single institution experience

Objective. - To compare perioperative outcomes of robot-assisted partial nephrectomy (RAPN) and laparoscopic partial nephrectomy (LPN) in a single French institution. Patients. - Between February 2008 and April 2012, 98 patients underwent RAPN (n = 54) or NPL (n=44) for a kidney tumor. Demographic data, perioperative and pathological outcomes were compared using Student's test and chi(2) for continuous and categorical variables, respectively. Results. - Both groups were comparable for age, BMI, American Society of Anesthesiologists classification (ASA) and preoperative renal function (MDRD clearance). Tumor complexity was increased in the RAPN group (55.5% vs. 29.5% RENAL score >= 2, P=0.05). There was no significant difference in terms of operative time (191 vs. 202 min, P=0.2), tumor size (35 vs. 30 mm, P=0.1) or positive margins (2 vs. 5, P=0.14). However, there was a significant decrease in warm ischemia time (18 vs. 25.6 min, P=0.004) and hospital stay (5.1 vs. 6.9 days, P=0.003) for RAPN. Estimated blood loss was greater in the RAPN group (490 vs. 280 mL, P=0.003), but the numbers of transfusions were similar (5 vs. 4 patients, P=0.96). Urinary tract was more frequently entered in the RAPN group (28 vs. 12, P=0.009). The complication rate was similar in both groups (28% vs. 32%, P=0.66). Conclusion. - RAPN is feasible and reproducible. As in previous publications, our study confirms a potential benefit of RAPN concerning warm ischemia. (C) 2012 Elsevier Masson SAS. All rights reserved.