Robotic Versus Laparoscopic Partial Nephrectomy: A Prospective, Randomized Trial Comparing Two Surgical Techniques

Oberhammer L, Lusuardi L, Kunit T, Griessner H, Pallauf M, Eiben C, Oswald D and Mitterberger MJ

Department of Urology and Andrology, Paracelsus Medical University of Salzburg, Austria

^*Correspondance to: Lukas Oberhammer 

 PDF  Full Text DOI: 10.25107/2474-1647.3707

Abstract

Purpose: To compare oncological, peri-, and post-operative outcomes of robot-assisted with those of laparoscopic partial nephrectomy. Patients and Methods: Thirty patients with low- or moderate-complexity renal tumors (R.E.N.A.L. nephrometry scoring) were randomized in a single-blind manner and operated on by the robotassisted (n=13) or laparoscopic (n=17) approach. The primary outcome was oncological safety, based on the Residual tumor (R) classification. Secondary outcome parameters were perioperative and postoperative results. The open-source R statistical software was used for statistical analysis. Results: Oncological outcomes did not differ significantly between the two surgical methods (p=0.58). Operating time (p=0.105), ischemia time (p=0.884), overall length of hospital stay (p=0.664), postoperative pain, and preoperative and in-hospital renal function scores were similar. Creatinine levels differed significantly six months postoperatively (robotic: 0.9 mg/dl vs. laparoscopic: 1.1 mg/ dl; p=0.014). Intraoperative blood loss was significantly greater in the laparoscopic group (400 ml vs. 168 ml; p=0.028), which was also reflected in postoperative hemoglobin levels (13.8 mg/dl vs. 12.5 mg/dl; p=0.012). Peri- or post-operative complications did not differ significantly (p=0.355). Subgroup analysis revealed significantly more frequent complications in patients with moderatecomplexity tumors treated by laparoscopic surgery (p=0.021). Conclusion: The oncological outcome in regard to the R status was similar in both groups. Intraoperative blood loss, postoperative renal function, and complications all benefited from robotassisted surgery. Trial registration: The study was registered on ClinicalTrials.gov (NCT03900364; 03/04/2019).

Keywords

Robotic surgery; Laparoscopy; Partial nephrectomy; Renal cell carcinoma; Nephrometry score

Cite the article

Oberhammer L, Lusuardi L, Kunit T, Griessner H, Pallauf M, Eiben C, et al. Robotic Versus Laparoscopic Partial Nephrectomy: A Prospective, Randomized Trial Comparing Two Surgical Techniques. Clin Surg. 2024; 9: 3707.