Purely off-clamp robotic partial nephrectomy: Preliminary 3-year oncological and functional outcomes

Giuseppe Simone, Leonardo Misuraca, Gabriele Tuderti, Francesco Minisola, Mariaconsiglia Ferriero, Giuseppe Romeo, Manuela Costantini, Samer F. Al-Rawashdah, Salvatore Guaglianone, Michele Gallucci

Research output: Contribution to journalArticle

Abstract

Objectives: To describe our surgical technique and to report perioperative, 3-year oncological and functional outcomes of a single-center series of purely off-clamp robotic partial nephrectomy. Methods: A prospective renal cancer institutional database was queried, and data of consecutive patients treated with purely off-clamp robotic partial nephrectomy between 2010 and 2015 in a high-volume center were collected. Perioperative complications, and 3-year oncological and functional outcomes were assessed. Univariable and multivariable analyses were carried out to identify independent predictors of renal function deterioration. Results: Out of 308 patients treated, 41 (13.3%) experienced perioperative complications, 2.9% of which were Clavien grade ≥3. The 3-year local recurrence-free survival and renal cell carcinoma-specific survival rates were 99.5% and 97.9%, respectively. No patient with preoperative chronic kidney disease stage ≤3B developed severe renal function deterioration (chronic kidney disease stage 4) at 1-year follow up. At multivariable analysis, preoperative estimated glomerular filtration rate (P = 0.005) was the only independent predictor of a new-onset chronic kidney disease stage ≥3 in patients with preoperative chronic kidney disease stages 1 or 2. Conclusions: Off-clamp robotic partial nephrectomy is a safe surgical approach in tertiary referral centers, with adequate oncological outcomes and negligible impact on renal function.

Original languageEnglish
JournalInternational Journal of Urology
DOIs
Publication statusAccepted/In press - Jan 1 2018

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Keywords

  • Off-clamp
  • Oncological outcomes
  • Partial nephrectomy
  • Renal function
  • Robotic

ASJC Scopus subject areas

  • Urology

Cite this

Simone, G., Misuraca, L., Tuderti, G., Minisola, F., Ferriero, M., Romeo, G., Costantini, M., Al-Rawashdah, S. F., Guaglianone, S., & Gallucci, M. (Accepted/In press). Purely off-clamp robotic partial nephrectomy: Preliminary 3-year oncological and functional outcomes. International Journal of Urology. https://doi.org/10.1111/iju.13580