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Open versus robot‐assisted partial nephrectomy: A longitudinal comparison of 880 patients over 10 years
Background Most comparisons between robot‐assisted partial nephrectomy (RAPN) and open partial nephrectomy (OPN) indicate the superiority of RAPN, but the learning curve is often not considered. Methods All consecutive partial nephrectomies from the very first RAPN at a single tertiary referral cent...
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| Published in: | The international journal of medical robotics + computer assisted surgery 2021-02, Vol.17 (1), p.1-8 |
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| container_title | The international journal of medical robotics + computer assisted surgery |
| container_volume | 17 |
| creator | Zeuschner, Philip Greguletz, Leonie Meyer, Irmengard Linxweiler, Johannes Janssen, Martin Wagenpfeil, Gudrun Wagenpfeil, Stefan Siemer, Stefan Stöckle, Michael Saar, Matthias |
| description | Background
Most comparisons between robot‐assisted partial nephrectomy (RAPN) and open partial nephrectomy (OPN) indicate the superiority of RAPN, but the learning curve is often not considered.
Methods
All consecutive partial nephrectomies from the very first RAPN at a single tertiary referral centre (n = 818, 500 RAPN vs. 313 OPN) were retrospectively analyzed. Complications, success rates and surgical outcomes were compared. Inequalities between cohorts and the inherent learning curve were controlled by subgroup comparisons, regression analyses, and propensity score matching.
Results
Overall, RAPN had fewer complications, less blood loss, and shorter length of stay. However, an inherent learning curve caused higher complications for the first 4 years. Thereafter, perioperative outcomes clearly favoured RAPN, even for more complex tumours.
Conclusions
In one of the largest monocentric cohorts over more than 10 years, RAPN was found to be superior to OPN. However, not all advantages of RAPN are immediate because a learning curve must be passed. |
| doi_str_mv | 10.1002/rcs.2167 |
| format | article |
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Most comparisons between robot‐assisted partial nephrectomy (RAPN) and open partial nephrectomy (OPN) indicate the superiority of RAPN, but the learning curve is often not considered.
Methods
All consecutive partial nephrectomies from the very first RAPN at a single tertiary referral centre (n = 818, 500 RAPN vs. 313 OPN) were retrospectively analyzed. Complications, success rates and surgical outcomes were compared. Inequalities between cohorts and the inherent learning curve were controlled by subgroup comparisons, regression analyses, and propensity score matching.
Results
Overall, RAPN had fewer complications, less blood loss, and shorter length of stay. However, an inherent learning curve caused higher complications for the first 4 years. Thereafter, perioperative outcomes clearly favoured RAPN, even for more complex tumours.
Conclusions
In one of the largest monocentric cohorts over more than 10 years, RAPN was found to be superior to OPN. However, not all advantages of RAPN are immediate because a learning curve must be passed.</description><identifier>ISSN: 1478-5951</identifier><identifier>EISSN: 1478-596X</identifier><identifier>DOI: 10.1002/rcs.2167</identifier><identifier>PMID: 32920997</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>CAS ; Computer assisted surgery ; Kidney cancer ; Kidneys ; Learning curves ; Longitudinal studies ; minimally invasive surgery ; nephrectomy ; partial robot‐assisted partial nephrectomy ; Regression analysis ; renal cell carcinoma ; Robots ; Subgroups</subject><ispartof>The international journal of medical robotics + computer assisted surgery, 2021-02, Vol.17 (1), p.1-8</ispartof><rights>2020 The Authors. The International Journal of Medical Robotics and Computer Assisted Surgery published by John Wiley & Sons Ltd.</rights><rights>2020. This article is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3837-283dca5d572006c7366e707051642aeba96390a26ce2cd41d7c7742af7df482b3</citedby><cites>FETCH-LOGICAL-c3837-283dca5d572006c7366e707051642aeba96390a26ce2cd41d7c7742af7df482b3</cites><orcidid>0000-0001-8898-6588</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32920997$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zeuschner, Philip</creatorcontrib><creatorcontrib>Greguletz, Leonie</creatorcontrib><creatorcontrib>Meyer, Irmengard</creatorcontrib><creatorcontrib>Linxweiler, Johannes</creatorcontrib><creatorcontrib>Janssen, Martin</creatorcontrib><creatorcontrib>Wagenpfeil, Gudrun</creatorcontrib><creatorcontrib>Wagenpfeil, Stefan</creatorcontrib><creatorcontrib>Siemer, Stefan</creatorcontrib><creatorcontrib>Stöckle, Michael</creatorcontrib><creatorcontrib>Saar, Matthias</creatorcontrib><title>Open versus robot‐assisted partial nephrectomy: A longitudinal comparison of 880 patients over 10 years</title><title>The international journal of medical robotics + computer assisted surgery</title><addtitle>Int J Med Robot</addtitle><description>Background
Most comparisons between robot‐assisted partial nephrectomy (RAPN) and open partial nephrectomy (OPN) indicate the superiority of RAPN, but the learning curve is often not considered.
Methods
All consecutive partial nephrectomies from the very first RAPN at a single tertiary referral centre (n = 818, 500 RAPN vs. 313 OPN) were retrospectively analyzed. Complications, success rates and surgical outcomes were compared. Inequalities between cohorts and the inherent learning curve were controlled by subgroup comparisons, regression analyses, and propensity score matching.
Results
Overall, RAPN had fewer complications, less blood loss, and shorter length of stay. However, an inherent learning curve caused higher complications for the first 4 years. Thereafter, perioperative outcomes clearly favoured RAPN, even for more complex tumours.
Conclusions
In one of the largest monocentric cohorts over more than 10 years, RAPN was found to be superior to OPN. However, not all advantages of RAPN are immediate because a learning curve must be passed.</description><subject>CAS</subject><subject>Computer assisted surgery</subject><subject>Kidney cancer</subject><subject>Kidneys</subject><subject>Learning curves</subject><subject>Longitudinal studies</subject><subject>minimally invasive surgery</subject><subject>nephrectomy</subject><subject>partial robot‐assisted partial nephrectomy</subject><subject>Regression analysis</subject><subject>renal cell carcinoma</subject><subject>Robots</subject><subject>Subgroups</subject><issn>1478-5951</issn><issn>1478-596X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><recordid>eNp1kNFKHTEQhoNU1J4WfAIJ9MabtUk2m2y8k0O1giCohd4tOdlZjexu1syu5dz1EXxGn8ScnlMFwasZmG--YX5C9jk74oyJ79HhkeBKb5E9LnWZFUb9_vTaF3yXfEa8Z0wWUskdspsLI5gxeo_4ywF6-ggRJ6QxLML4_PfJInocoaaDjaO3Le1huIvgxtAtj-kJbUN_68ep9n2audAlzGPoaWhoWbK0NXroR6QheSlndAk24hey3dgW4eumzsiv0x8385_ZxeXZ-fzkInN5metMlHntbFEXWjCmnM6VAs00K7iSwsLCGpUbZoVyIFwtea2d1mnS6LqRpVjkM3K49g4xPEyAY9V5dNC2tocwYSWkFIUpTbo2I9_eofdhiumpFaWNVnmpxJvQxYAYoamG6DsblxVn1Sr-KsVfreJP6MFGOC06qF_B_3knIFsDf3wLyw9F1dX8-p_wBc4sjso</recordid><startdate>202102</startdate><enddate>202102</enddate><creator>Zeuschner, Philip</creator><creator>Greguletz, Leonie</creator><creator>Meyer, Irmengard</creator><creator>Linxweiler, Johannes</creator><creator>Janssen, Martin</creator><creator>Wagenpfeil, Gudrun</creator><creator>Wagenpfeil, Stefan</creator><creator>Siemer, Stefan</creator><creator>Stöckle, Michael</creator><creator>Saar, Matthias</creator><general>Wiley Subscription Services, Inc</general><scope>24P</scope><scope>WIN</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7SC</scope><scope>7SP</scope><scope>7TB</scope><scope>8FD</scope><scope>F28</scope><scope>FR3</scope><scope>JQ2</scope><scope>K9.</scope><scope>L7M</scope><scope>L~C</scope><scope>L~D</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8898-6588</orcidid></search><sort><creationdate>202102</creationdate><title>Open versus robot‐assisted partial nephrectomy: A longitudinal comparison of 880 patients over 10 years</title><author>Zeuschner, Philip ; Greguletz, Leonie ; Meyer, Irmengard ; Linxweiler, Johannes ; Janssen, Martin ; Wagenpfeil, Gudrun ; Wagenpfeil, Stefan ; Siemer, Stefan ; Stöckle, Michael ; Saar, Matthias</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3837-283dca5d572006c7366e707051642aeba96390a26ce2cd41d7c7742af7df482b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>CAS</topic><topic>Computer assisted surgery</topic><topic>Kidney cancer</topic><topic>Kidneys</topic><topic>Learning curves</topic><topic>Longitudinal studies</topic><topic>minimally invasive surgery</topic><topic>nephrectomy</topic><topic>partial robot‐assisted partial nephrectomy</topic><topic>Regression analysis</topic><topic>renal cell carcinoma</topic><topic>Robots</topic><topic>Subgroups</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zeuschner, Philip</creatorcontrib><creatorcontrib>Greguletz, Leonie</creatorcontrib><creatorcontrib>Meyer, Irmengard</creatorcontrib><creatorcontrib>Linxweiler, Johannes</creatorcontrib><creatorcontrib>Janssen, Martin</creatorcontrib><creatorcontrib>Wagenpfeil, Gudrun</creatorcontrib><creatorcontrib>Wagenpfeil, Stefan</creatorcontrib><creatorcontrib>Siemer, Stefan</creatorcontrib><creatorcontrib>Stöckle, Michael</creatorcontrib><creatorcontrib>Saar, Matthias</creatorcontrib><collection>Wiley Open Access</collection><collection>Wiley Online Library Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Computer and Information Systems Abstracts</collection><collection>Electronics & Communications Abstracts</collection><collection>Mechanical & Transportation Engineering Abstracts</collection><collection>Technology Research Database</collection><collection>ANTE: Abstracts in New Technology & Engineering</collection><collection>Engineering Research Database</collection><collection>ProQuest Computer Science Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Advanced Technologies Database with Aerospace</collection><collection>Computer and Information Systems Abstracts Academic</collection><collection>Computer and Information Systems Abstracts Professional</collection><collection>MEDLINE - Academic</collection><jtitle>The international journal of medical robotics + computer assisted surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zeuschner, Philip</au><au>Greguletz, Leonie</au><au>Meyer, Irmengard</au><au>Linxweiler, Johannes</au><au>Janssen, Martin</au><au>Wagenpfeil, Gudrun</au><au>Wagenpfeil, Stefan</au><au>Siemer, Stefan</au><au>Stöckle, Michael</au><au>Saar, Matthias</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Open versus robot‐assisted partial nephrectomy: A longitudinal comparison of 880 patients over 10 years</atitle><jtitle>The international journal of medical robotics + computer assisted surgery</jtitle><addtitle>Int J Med Robot</addtitle><date>2021-02</date><risdate>2021</risdate><volume>17</volume><issue>1</issue><spage>1</spage><epage>8</epage><pages>1-8</pages><issn>1478-5951</issn><eissn>1478-596X</eissn><abstract>Background
Most comparisons between robot‐assisted partial nephrectomy (RAPN) and open partial nephrectomy (OPN) indicate the superiority of RAPN, but the learning curve is often not considered.
Methods
All consecutive partial nephrectomies from the very first RAPN at a single tertiary referral centre (n = 818, 500 RAPN vs. 313 OPN) were retrospectively analyzed. Complications, success rates and surgical outcomes were compared. Inequalities between cohorts and the inherent learning curve were controlled by subgroup comparisons, regression analyses, and propensity score matching.
Results
Overall, RAPN had fewer complications, less blood loss, and shorter length of stay. However, an inherent learning curve caused higher complications for the first 4 years. Thereafter, perioperative outcomes clearly favoured RAPN, even for more complex tumours.
Conclusions
In one of the largest monocentric cohorts over more than 10 years, RAPN was found to be superior to OPN. However, not all advantages of RAPN are immediate because a learning curve must be passed.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>32920997</pmid><doi>10.1002/rcs.2167</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-8898-6588</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | CAS Computer assisted surgery Kidney cancer Kidneys Learning curves Longitudinal studies minimally invasive surgery nephrectomy partial robot‐assisted partial nephrectomy Regression analysis renal cell carcinoma Robots Subgroups |
| title | Open versus robot‐assisted partial nephrectomy: A longitudinal comparison of 880 patients over 10 years |
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