A multicentre matched-pair analysis comparing robot-assisted versus open partial nephrectomy

Vincenzo Ficarra, Andrea Minervini, Alessandro Antonelli, Sam Bhayani, Giorgio Guazzoni, Nicola Longo, Giuseppe Martorana, Giuseppe Morgia, Alexander Mottrie, James Porter, Claudio Simeone, Gianni Vittori, Filiberto Zattoni, Marco Carini

Research output: Contribution to journalArticle

61 Citations (Scopus)

Abstract

Objective To compare the perioperative, pathological and functional outcomes in two contemporary, large series of patients in different institutions and who underwent open partial nephrectomy (OPN) or robot-assisted PN (RAPN) for suspected renal tumours. Patients and Methods This was a retrospective, multicentre, international, matched-pair analysis comparing patients who underwent RAPN or OPN for suspected renal cell carcinoma. Data on patients who underwent OPN were extracted by an Italian observational registry collecting data from 19 different centres. Data on patients who received RAPN were extracted from a multicentre, international database collecting cases treated in four high-volume referral centres of robotic surgery. The matching was in a 1:1 ratio for the surgical approach and included 200 patients in each arm. Results The mean warm ischaemia time was shorter in the OPN group than in the RAPN group, at a mean (sd) of 15.4 (5.9) vs 19.2 (7.3) min (P <0.001). Conversely, the median (interquartile range) estimated blood loss was 150 (100-300) mL in the OPN group and 100 (50-150) mL in the RAPN group (P <0.001). There were no differences in operating time (P = 0.18) and the intraoperative complication rate (P = 0.31) between the approaches. Postoperative complications were recorded in 43 (21.5%) patients who underwent OPN and in 28 (14%) who received RAPN (P = 0.02). Moreover, major complications (grade 3-4) were reported in nine (4.5%) patients after OPN and in nine (4.5%) after RAPN. Positive margins were detected in nine (5.5%) patients after OPN and in nine (5.7%) after RAPN (P = 0.98). The mean (sd) 3-month estimated glomerular filtration rate declined by 16.6 (18.1) mL/min from the preoperative value in the OPN group and by 16.4 (22.9) mL/min in the RAPN group (P = 0.28). Conclusion RAPN can achieve equivalent perioperative, early oncological and functional outcomes as OPN. Moreover, RAPN is a less invasive approach, offering a lower risk of bleeding and postoperative complications than OPN.

Original languageEnglish
Pages (from-to)936-941
Number of pages6
JournalBJU International
Volume113
Issue number6
DOIs
Publication statusPublished - 2014

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Matched-Pair Analysis
Nephrectomy
Warm Ischemia
Intraoperative Complications
Robotics
Glomerular Filtration Rate
Renal Cell Carcinoma
Registries
Referral and Consultation
Databases

Keywords

  • complications
  • kidney
  • partial nephrectomy
  • renal tumour
  • robotics

ASJC Scopus subject areas

  • Urology

Cite this

Ficarra, V., Minervini, A., Antonelli, A., Bhayani, S., Guazzoni, G., Longo, N., ... Carini, M. (2014). A multicentre matched-pair analysis comparing robot-assisted versus open partial nephrectomy. BJU International, 113(6), 936-941. https://doi.org/10.1111/bju.12570

A multicentre matched-pair analysis comparing robot-assisted versus open partial nephrectomy. / Ficarra, Vincenzo; Minervini, Andrea; Antonelli, Alessandro; Bhayani, Sam; Guazzoni, Giorgio; Longo, Nicola; Martorana, Giuseppe; Morgia, Giuseppe; Mottrie, Alexander; Porter, James; Simeone, Claudio; Vittori, Gianni; Zattoni, Filiberto; Carini, Marco.

In: BJU International, Vol. 113, No. 6, 2014, p. 936-941.

Research output: Contribution to journalArticle

Ficarra, V, Minervini, A, Antonelli, A, Bhayani, S, Guazzoni, G, Longo, N, Martorana, G, Morgia, G, Mottrie, A, Porter, J, Simeone, C, Vittori, G, Zattoni, F & Carini, M 2014, 'A multicentre matched-pair analysis comparing robot-assisted versus open partial nephrectomy', BJU International, vol. 113, no. 6, pp. 936-941. https://doi.org/10.1111/bju.12570
Ficarra V, Minervini A, Antonelli A, Bhayani S, Guazzoni G, Longo N et al. A multicentre matched-pair analysis comparing robot-assisted versus open partial nephrectomy. BJU International. 2014;113(6):936-941. https://doi.org/10.1111/bju.12570
Ficarra, Vincenzo ; Minervini, Andrea ; Antonelli, Alessandro ; Bhayani, Sam ; Guazzoni, Giorgio ; Longo, Nicola ; Martorana, Giuseppe ; Morgia, Giuseppe ; Mottrie, Alexander ; Porter, James ; Simeone, Claudio ; Vittori, Gianni ; Zattoni, Filiberto ; Carini, Marco. / A multicentre matched-pair analysis comparing robot-assisted versus open partial nephrectomy. In: BJU International. 2014 ; Vol. 113, No. 6. pp. 936-941.
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abstract = "Objective To compare the perioperative, pathological and functional outcomes in two contemporary, large series of patients in different institutions and who underwent open partial nephrectomy (OPN) or robot-assisted PN (RAPN) for suspected renal tumours. Patients and Methods This was a retrospective, multicentre, international, matched-pair analysis comparing patients who underwent RAPN or OPN for suspected renal cell carcinoma. Data on patients who underwent OPN were extracted by an Italian observational registry collecting data from 19 different centres. Data on patients who received RAPN were extracted from a multicentre, international database collecting cases treated in four high-volume referral centres of robotic surgery. The matching was in a 1:1 ratio for the surgical approach and included 200 patients in each arm. Results The mean warm ischaemia time was shorter in the OPN group than in the RAPN group, at a mean (sd) of 15.4 (5.9) vs 19.2 (7.3) min (P <0.001). Conversely, the median (interquartile range) estimated blood loss was 150 (100-300) mL in the OPN group and 100 (50-150) mL in the RAPN group (P <0.001). There were no differences in operating time (P = 0.18) and the intraoperative complication rate (P = 0.31) between the approaches. Postoperative complications were recorded in 43 (21.5{\%}) patients who underwent OPN and in 28 (14{\%}) who received RAPN (P = 0.02). Moreover, major complications (grade 3-4) were reported in nine (4.5{\%}) patients after OPN and in nine (4.5{\%}) after RAPN. Positive margins were detected in nine (5.5{\%}) patients after OPN and in nine (5.7{\%}) after RAPN (P = 0.98). The mean (sd) 3-month estimated glomerular filtration rate declined by 16.6 (18.1) mL/min from the preoperative value in the OPN group and by 16.4 (22.9) mL/min in the RAPN group (P = 0.28). Conclusion RAPN can achieve equivalent perioperative, early oncological and functional outcomes as OPN. Moreover, RAPN is a less invasive approach, offering a lower risk of bleeding and postoperative complications than OPN.",
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T1 - A multicentre matched-pair analysis comparing robot-assisted versus open partial nephrectomy

AU - Ficarra, Vincenzo

AU - Minervini, Andrea

AU - Antonelli, Alessandro

AU - Bhayani, Sam

AU - Guazzoni, Giorgio

AU - Longo, Nicola

AU - Martorana, Giuseppe

AU - Morgia, Giuseppe

AU - Mottrie, Alexander

AU - Porter, James

AU - Simeone, Claudio

AU - Vittori, Gianni

AU - Zattoni, Filiberto

AU - Carini, Marco

PY - 2014

Y1 - 2014

N2 - Objective To compare the perioperative, pathological and functional outcomes in two contemporary, large series of patients in different institutions and who underwent open partial nephrectomy (OPN) or robot-assisted PN (RAPN) for suspected renal tumours. Patients and Methods This was a retrospective, multicentre, international, matched-pair analysis comparing patients who underwent RAPN or OPN for suspected renal cell carcinoma. Data on patients who underwent OPN were extracted by an Italian observational registry collecting data from 19 different centres. Data on patients who received RAPN were extracted from a multicentre, international database collecting cases treated in four high-volume referral centres of robotic surgery. The matching was in a 1:1 ratio for the surgical approach and included 200 patients in each arm. Results The mean warm ischaemia time was shorter in the OPN group than in the RAPN group, at a mean (sd) of 15.4 (5.9) vs 19.2 (7.3) min (P <0.001). Conversely, the median (interquartile range) estimated blood loss was 150 (100-300) mL in the OPN group and 100 (50-150) mL in the RAPN group (P <0.001). There were no differences in operating time (P = 0.18) and the intraoperative complication rate (P = 0.31) between the approaches. Postoperative complications were recorded in 43 (21.5%) patients who underwent OPN and in 28 (14%) who received RAPN (P = 0.02). Moreover, major complications (grade 3-4) were reported in nine (4.5%) patients after OPN and in nine (4.5%) after RAPN. Positive margins were detected in nine (5.5%) patients after OPN and in nine (5.7%) after RAPN (P = 0.98). The mean (sd) 3-month estimated glomerular filtration rate declined by 16.6 (18.1) mL/min from the preoperative value in the OPN group and by 16.4 (22.9) mL/min in the RAPN group (P = 0.28). Conclusion RAPN can achieve equivalent perioperative, early oncological and functional outcomes as OPN. Moreover, RAPN is a less invasive approach, offering a lower risk of bleeding and postoperative complications than OPN.

AB - Objective To compare the perioperative, pathological and functional outcomes in two contemporary, large series of patients in different institutions and who underwent open partial nephrectomy (OPN) or robot-assisted PN (RAPN) for suspected renal tumours. Patients and Methods This was a retrospective, multicentre, international, matched-pair analysis comparing patients who underwent RAPN or OPN for suspected renal cell carcinoma. Data on patients who underwent OPN were extracted by an Italian observational registry collecting data from 19 different centres. Data on patients who received RAPN were extracted from a multicentre, international database collecting cases treated in four high-volume referral centres of robotic surgery. The matching was in a 1:1 ratio for the surgical approach and included 200 patients in each arm. Results The mean warm ischaemia time was shorter in the OPN group than in the RAPN group, at a mean (sd) of 15.4 (5.9) vs 19.2 (7.3) min (P <0.001). Conversely, the median (interquartile range) estimated blood loss was 150 (100-300) mL in the OPN group and 100 (50-150) mL in the RAPN group (P <0.001). There were no differences in operating time (P = 0.18) and the intraoperative complication rate (P = 0.31) between the approaches. Postoperative complications were recorded in 43 (21.5%) patients who underwent OPN and in 28 (14%) who received RAPN (P = 0.02). Moreover, major complications (grade 3-4) were reported in nine (4.5%) patients after OPN and in nine (4.5%) after RAPN. Positive margins were detected in nine (5.5%) patients after OPN and in nine (5.7%) after RAPN (P = 0.98). The mean (sd) 3-month estimated glomerular filtration rate declined by 16.6 (18.1) mL/min from the preoperative value in the OPN group and by 16.4 (22.9) mL/min in the RAPN group (P = 0.28). Conclusion RAPN can achieve equivalent perioperative, early oncological and functional outcomes as OPN. Moreover, RAPN is a less invasive approach, offering a lower risk of bleeding and postoperative complications than OPN.

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