Presented by: Tunkut Doganca MD
Acibadem Taksim Hospital, Urology

Introduction

The aim of this study is to compare perioperative outcomes of robot assisted partial nephrectomy (RAPN) in T1a and T1b renal masses.

Materials

This is a retrospective analysis of RAPN patients operated between 2008 and 2023 in a single institution. A total of 265 patients with T1a and 98 with T1b tumors underwent RAPN.

Results

,

Mean age and BMI in T1a patients were 53.89 ± 12.43 and 27.48 ± 4.33 kg/m² and 52.23 ± 14.5 and 28.68 ± 5.17 kg/m² in T1b patients, respectively. Mean tumor size was 26.78 ± 7.87 mm. in T1a and 49.46 ± 8.06 mm. in T1b patients. In T1a group, mean operative and warm ischemia times (WIT) were 97.14 ± 40.89 and 15.33 ± 8.7 minutes and in T1b group, 118.79 ± 36.9 and 18.78 ± 7.74 minutes, respectively. Mean estimated blood loss was 176.98 ± 201.03 and 263.57 ± 194.93 ml. in T1a and T1b patients, respectively. Surgical margins were positive in 6 (2%) T1a patients and in 3 (3%) T1b patients. Eleven patients (4% in T1a, 11% in T1b) had complications in each group; (1 Clavien I, 2 Clavien II, 8 Clavien IIIB in T1a) (2 Clavien I, 1 Clavien II, 7 Clavien IIIB and 1 Clavien IVA in T1b). Mean preoperative and postoperative creatinine were 0.88 ± 0.22 and 0.9 ± 0.25 mg/dl in T1a patients and 0.87 ± 0.21 and 0.93 ± 0.28 mg/dl in T1b patients, respectively. Mean preoperative and postoperative eGFR were 91.04 ± 18.74 and 89.62 ± 19.82 ml/min/1.73m² in T1a patients and 93.22 ± 19.6 and 88.8 ± 21.13 ml/min/1.73m² in T1b patients, respectively.

Conclusion

Compared to T1a renal masses, RAPN can be performed in T1b renal masses with slightly longer operative and warm ischemia times, higher complication rates and similar surgical margin positivity and renal function preservation rates.

Funding

None

Co-Authors

Mustafa Bilal Tuna, MD
Acibadem Maslak Hospital

Ilter Tufek, MD, Prof.
Acibadem University, School of Medicine, Urology

Omer Burak Argun, MD, Assoc. Prof.
Acibadem University, School of Medicine, Urology

Can Obek, Md, Prof.
Acibadem University, School of Medicine, Urology

Ali Rıza Kural, MD, Prof.
Acibadem University, School of Medicine, Urology