Evaluation of oncological and functional outcomes in robot-assisted partial nephrectomy for renal tumors with intermediate and high risk RENAL nephrometry scores

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.

RENAL nefrometri skoru orta ve yüksek risk grubu renal kitlelerde robot yardýmlý parsiyel nefrektominin onkolojik ve fonksiyonel sonuçlarýnýn deðerlendirilmesi

GÝRÝÞ ve AMAÇ: RENAL nefrometri skoru 7 ve üzerinde olan renal kitlelerde robot yardýmlý parsiyel nefrektominin perioperatif, onkolojik ve fonksiyonel sonuçlarýnýn deðerlendirilmesi.
YÖNTEM ve GEREÇLER: Nisan 2015- Mart 2019 tarihleri arasýnda robotic parsiyel nefrektomi uygulanan ve nefrometri skoru 7 ve üzeri olan vakalarýn demografik, perioperatif ve postoperatif verileri retrospektif olarak deðerlendirildi. Soliter böbrekli, sýcak iskemi uygulanmayan, multiple renal kitlesi olan ve retroperitoneal teknikle parsiyel nefrektomi uygulanan hastalar çalýþma dýþý býrakýldý.
BULGULAR: Hastalarýn ortalama yaþý 58.08 ± 12.71 yýl idi. Ortalama tümör çapý, RENAL skor, preoperative eGFR deðerleri sýrasýyla 4.19 ± 1.56 cm, 7.88 ± 1.12 ve 78.73 ± 18.10 ml/min/1.73m² idi. Ortalama operasyon süresi, kanama miktarý, hastanede kalýþ süresi sýrasýyla 156.15 ± 45.70 dk, 139.06 ± 72.96 mL ve 3.58 ± 1.03 gün þeklindeydi. Açýða ve radikal nefrektomiye dönüþ izlenmedi. Cerrahi sýnýr pozitifliði 2 (4.2%) hastada izlendi. Postoperatif 12. Ay eGFR deðiþimi -7.19± 8.83 ml/min/1.73m² (9.13%) idi. Yeni baþlangýçlý Evre 3-4 kronik böbrek yetmezliði (eGFR< 60 ml/min/1.73m²) oraný 6.3% olarak saptandý. Hastalarýn ortalama takip süresi 35.08 ± 11.09 ay idi. Takip boyunca kansere baðlý ölüm izlenmezken, genel saðkalým 95.8% olarak saptandý.
TARTIÞMA ve SONUÇ: Robot yardýmlý parsiyel nefrektomi RENAL skoru orta-yüksek risk grubu renal kitlelerde güvenilir onkolojik ve fonksiyonel sonuçlarla baþarýyla uygulanabilir cerrahi bir yöntemdir.