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Efficacy of robot-assisted partial nephrectomy compared to conventional laparoscopic partial nephrectomy for completely endophytic renal tumor: a multicenter, prospective study.
Hinata, Nobuyuki; Murakami, Sae; Nakano, Yuzo; Hara, Isao; Kondo, Tsunenori; Hamamoto, Shuzo; Shiroki, Ryoichi; Nagayama, Jun; Kawakita, Mutsushi; Eto, Masatoshi; Ukimura, Osamu; Takenaka, Atsushi; Takagi, Toshio; Shimbo, Masaki; Azuma, Haruhito; Yoshida, Tetsuya; Furukawa, Junya; Kawamorita, Naoki; Fujisawa, Masato.
Afiliación
  • Hinata N; Department of Urology, Graduate School of Biomedical and Health Sciences Hiroshima University, 1-2-3, Kasumi Minami-ku, Hiroshima, 734-8551, Japan. hinata@hiroshima-u.ac.jp.
  • Murakami S; Department of Urology, Kobe University Graduate School of Medicine, Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 657-0017, Japan. hinata@hiroshima-u.ac.jp.
  • Nakano Y; Clinical and Translational Research Center, Kobe University Hospital, Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan.
  • Hara I; Department of Urology, Kobe University Graduate School of Medicine, Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 657-0017, Japan.
  • Kondo T; Department of Urology, Wakayama Medical University, 811-1 Kimiidera, Wakayama, Wakayama, 641-8509, Japan.
  • Hamamoto S; Department of Urology, Tokyo Women's Medical University, Adachi Medical Center, 4-33-1, Kohoku, Adachi-Ku, Tokyo, 123-8558, Japan.
  • Shiroki R; Department of Nephro-urology, Nagoya City University, 1, Kawasumi Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8602, Japan.
  • Nagayama J; Department of Urology, Fujita-Health University School of Medicine, Toyoake City, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, Japan.
  • Kawakita M; Department of Urology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aich, 466-8560, Japan.
  • Eto M; Department of Urology, Kobe City Medical Center General Hospital, 2-1-1 Minatojima Minamimachi, Chuo-ku, Kobe, Hyogo, 650-0047, Japan.
  • Ukimura O; Department of Urology, Kyushu University, 744 Motooka Nishi-ku, Fukuoka, Fukuoka, 819-0395, Japan.
  • Takenaka A; Department of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajiicho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Kyoto, 602-8566, Japan.
  • Takagi T; Division of Urology, Department of Surgery, Graduate School of Medicine, Faculty of Medicine, Tottori University, 36-1, Nishicho, Yonago, Tottori, 683-8504, Japan.
  • Shimbo M; Department of Urology, Tokyo Women's Medical University Hospital, 8-1, Kawadacho, Shinjuku-Ku, Tokyo, 162-8666, Japan.
  • Azuma H; Department of Urology, St. Luke's International Hospital, 9-1, Akashicho, Chuo-Ku, Tokyo, 104-0044, Japan.
  • Yoshida T; Department of Urology, Osaka Medical and Pharmaceutical University Hospital, 2-7 Daigakumachi, Takatsuki, Osaka, 569-8686, Japan.
  • Furukawa J; Department of Urology, Shiga University of Medical Science Hospital, Seta-Tsukinowatyo Seta, Ohtsu, Shiga, 520-2192, Japan.
  • Kawamorita N; Department of Urology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15, Kuramoto-cho, Tokushima, Tokushima, 770-8503, Japan.
  • Fujisawa M; Department of Urology, Tohoku University Graduate School of Medicine, Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
Int J Clin Oncol ; 29(10): 1548-1556, 2024 Oct.
Article en En | MEDLINE | ID: mdl-39110358
ABSTRACT

BACKGROUND:

This study aimed to compare the efficacy of robot-assisted partial nephrectomy for completely endophytic renal tumors with the reported outcomes of conventional laparoscopic partial nephrectomy and investigate the transition of renal function after robot-assisted partial nephrectomy.

METHODS:

We conducted a prospective, multicenter, single-arm, open-label trial across 17 academic centers in Japan. Patients with endophytic renal tumors classified as cT1, cN0, cM0 were included and underwent robot-assisted partial nephrectomy. We defined two primary outcomes to assess functional and oncological aspects of the procedure, which were represented by the warm ischemic time and positive surgical margin, respectively. Comparisons were made using control values previously reported in laparoscopic partial nephrectomy studies. In the historical control group, the warm ischemia time was 25.2, and the positive surgical margin was 13%.

RESULTS:

Our per-protocol analysis included 98 participants. The mean warm ischemic time was 20.3 min (99% confidence interval 18.3-22.3; p < 0.0001 vs. 25.2). None of the 98 participants had a positive surgical margin (99% confidence interval 0-5.3%; p < 0.0001 vs. 13.0%). The renal function ratio of eGFR before and after protocol treatment multiplied by splits was 0.70 (95% confidence interval 0.66-0.75). Factors such as preoperative eGFR, resected weight, and warm ischemic time influenced the functional loss of the partially nephrectomized kidney after robot-assisted partial nephrectomy.

CONCLUSIONS:

Robot-assisted partial nephrectomy for completely endophytic renal tumors offers a shorter warm ischemia time and comparable positive surgical margin rate compared with conventional laparoscopic partial nephrectomy.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Laparoscopía / Procedimientos Quirúrgicos Robotizados / Neoplasias Renales / Nefrectomía Límite: Aged / Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: Int J Clin Oncol Asunto de la revista: NEOPLASIAS Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Japón
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Laparoscopía / Procedimientos Quirúrgicos Robotizados / Neoplasias Renales / Nefrectomía Límite: Aged / Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: Int J Clin Oncol Asunto de la revista: NEOPLASIAS Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Japón