Abstract

INTRODUCTION

To evaluate the perioperative, oncological and functional outcomes of robot-assisted partial nephrectomy in renal masses with a RENAL nephrometry score ≥7.

METHODS

Demographics, perioperative and postoperative outcomes of robot-assisted partial nephrectomy with a RENAL nephrometry score ≥7 who operated between April 2015 and March 2019 were retrospectively evaluated. Patients with solitary kidney, zero ischemic, multiple renal mass and partial nephrectomy with retroperitoneal technique were excluded from the study.

RESULTS

The mean age of the patients was 58.08 ± 12.71 years. Mean tumor diameter, RENAL score, preoperative eGFR values were 4.19 ± 1.56 cm, 7.88 ± 1.12 and 78.73 ± 18.10 ml / min / 1.73m², respectively. The mean operation time, estimated blood loss, and length of hospital stay were 156.15 ± 45.70 min, 139.06 ± 72.96 mL and 3.58 ± 1.03 days, respectively. No conversion to open or radical nephrectomy was observed. Positive surgical margin was observed in 2 (4.2%) patients. The 12th month postoperative eGFR change was -7.19 ± 8.83 ml / min / 1.73m² (9.13%). The rate of new-onset Stage 3-4 chronic kidney disease (eGFR <60 ml / min / 1.73m²) was 6.3%. The mean follow-up period was 35.08 ± 11.09 months. Overall survival was 95.8%, while cancer-related death was not observed during follow-up.

DISCUSSION AND CONCLUSION

Robot-assisted partial nephrectomy with intermediate and high risk RENAL nephrometry scores is a safe surgical method that can be applied successfully with comparable oncological and functional results.