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Robotic-Assisted Versus Conventional Open Partial Nephrectomy (Robocop): A Propensity Score-Matched Analysis of 249 Patients

2021; Karger Publishers; Volume: 105; Issue: 5-6 Linguagem: Inglês

10.1159/000513189

1423-0399

Karl‐Friedrich Kowalewski, Dennis Müller, Marietta Kirchner, Regina Brinster, Julia Mühlbauer, Marie Angela Sidoti Abate, Margarete Teresa Walach, Philipp Nuhn, Patrick Honeck, M.S. Michel, Maximilian C. Kriegmair,

Bladder and Urothelial Cancer Treatments

<b><i>Objectives:</i></b> The objective of this study was to compare open partial nephrectomy (OPN) and robotic-assisted PN (RAPN) based on a propensity score-matched sample and to test the Comprehensive Complication Index (CCI) as an end point for complications. <b><i>Methods:</i></b> Patients undergoing PN from 2010 to 2018 at a university care center were included. OPN and RAPN cases were matched in a 2:1 ratio using propensity score-matching with age, gender, BMI, RENAL score, and tumor size as confounders. The primary end point was complications measured with the CCI as continuous score (0–100, 100 indicating death). <b><i>Results:</i></b> Data of 570 patients were available. After matching, both cohorts (OPN = 166; RAPN = 83) showed no baseline differences. For the primary end point, CCI, RAPN was superior (RAPN 2.6 ± 7.9 vs. OPN 8.7 ± 13.9; <i>p</i> &#x3c; 0.001). Additionally, RAPN was superior for length of stay (RAPN 6.5 ± 4.0 vs. OPN 7.4 ± 3.5 days; <i>p</i> &#x3c; 0.001), hemoglobin drop (RAPN 2.8 ± 1.4 vs. OPN 3.8 ± 1.6 g/dL; <i>p</i> &#x3c; 0.001), and drop of glomerular filtration rate (RAPN 11.4 ± 14.2 vs. OPN 19.5 ± 14.3 mL/min; <i>p</i> &#x3c; 0.001). OPN had shorter operating times (RAPN 157 ± 43 vs. OPN 143 ± 45 min; <i>p</i> = 0.014) and less ischemia (RAPN 13% vs. OPN 28%; <i>p</i> = 0.016). <b><i>Conclusions:</i></b> RAPN provides superior short-term results regarding overall complications without compromising renal function for small and less complex tumors. However, OPN remains an important option for more complex and larger tumors.