Multi-Institutional Analysis of Robotic Partial Nephrectomy for Hilar Versus Nonhilar Lesions in 446 Consecutive Cases

Abstract Background Minimally invasive approaches to partial nephrectomy have been rapidly gaining popularity but require advanced laparoscopic surgical skills. Renal hilar tumors, due to their anatomic location, pose additional technical challenges to the operating surgeon. Objective We compared th...

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Bibliographic Details
Published in:European urology 2011-03, Vol.59 (3), p.325-330
Main Authors: Dulabon, Lori M, Kaouk, Jihad H, Haber, Georges-Pascal, Berkman, Douglas S, Rogers, Craig G, Petros, Firas, Bhayani, Sam B, Stifelman, Michael D
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Biological and medical sciences
Female
Humans
Kidney Neoplasms - surgery
Kidneys
Male
Medical sciences
Middle Aged
Minimally Invasive Surgical Procedures - instrumentation
Minimally Invasive Surgical Procedures - methods
Nephrectomy - instrumentation
Nephrectomy - methods
Nephrology. Urinary tract diseases
Postoperative Complications
Retrospective Studies
Robotics - methods
Treatment Outcome
Tumors of the urinary system
Urology
Young Adult
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Summary:Abstract Background Minimally invasive approaches to partial nephrectomy have been rapidly gaining popularity but require advanced laparoscopic surgical skills. Renal hilar tumors, due to their anatomic location, pose additional technical challenges to the operating surgeon. Objective We compared the outcomes of robot-assisted partial nephrectomy (RPN) for hilar and nonhilar tumors in our large multicenter contemporary series of patients. Design, setting, and participants We retrospectively reviewed prospectively collected data on 446 consecutive patients who underwent RPN by renal surgeons experienced in minimally invasive techniques at four academic institutions from June 2006 to March 2010. Patients were stratified into two groups: those with hilar lesions and those with nonhilar lesions. Measurements Patient demographics, operative outcomes, and postoperative outcomes, including oncologic outcomes, were recorded. Results and limitations Forty-one patients (9%) had hilar renal masses; 405 patients (91%) had nonhilar masses. There was no statistical differences in patient demographics except for larger median tumor size in the hilar cohort (3.2 cm vs 2.6 cm; p = 0.001). The only significant difference in operative outcomes was an increase in warm ischemia times for the hilar group versus the nonhilar group (26.3 ± 7.4 min vs 19.6 ± 10.0 min; p =
ISSN:0302-2838
1873-7560
DOI:10.1016/j.eururo.2010.11.017