Comparison of open and robotic nephron sparing surgery: a single centre experience
Published online on September 28, 2016
Abstract
To compare robotic partial nephrectomy (RAPN) with open partial nephrectomy (OPN) to assess efficacy and impact of learning curve.
From 2010 to 2015 159 patients had a partial nephrectomy (82 OPN and 77 RAPN). All data were collected prospectively. We compared the demographics, peri and postoperative outcomes.
Mean age was 60 years in both groups; 59% of patients were men. Tumour size was larger in the open group (34 mm vs 30 mm; P<0.08), but RENAL nephrometry scores greater than 6 were comparable (over 60%). Mean ischaemic time was longer in the RAPN group (18 vs 13 minutes; P<0.04) but complication rates were similar. The RAPN cohort had a reduced estimated blood loss (100 ml vs 300 ml; P<0.01) and shorter median hospital stay (2 vs 5 days; P<0.01). Only two patients in each group were margin positive. The RAPN cohort demonstrated reduced estimated blood loss and a trend towards more complex tumours with increasing learning curve.
RAPN is superior to OPN in terms of reduced hospital stay and estimated blood loss without compromising oncological outcomes. This service can be delivered safely and effectively in a low to medium volume cancer centre; these results are similar to published figures from high volume international centres.