Operative and oncological outcomes of salvage robotic radical and partial nephrectomy: a multicenter experience
We aim to describe the perioperative and oncological outcomes for salvage robotic partial nephrectomy (sRPN) and salvage robotic radical nephrectomy (sRRN). Using a prospectively maintained multi-institutional database, we compared baseline clinical characteristics and perioperative and postoperativ...
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| Veröffentlicht in: | Journal of robotic surgery 2023-08, Vol.17 (4), p.1579-1585 |
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| creator | Okhawere, Kennedy E. Grauer, Ralph Zuluaga, Laura Meilika, Kirolos N. Ucpinar, Burak Beksac, Alp Tuna Razdan, Shirin Saini, Indu Abramowitz, Chiya Abaza, Ronney Eun, Daniel D. Bhandari, Akshay Hemal, Ashok K. Porter, James Stifelman, Michael D. Menon, Mani Badani, Ketan K. |
| description | We aim to describe the perioperative and oncological outcomes for salvage robotic partial nephrectomy (sRPN) and salvage robotic radical nephrectomy (sRRN). Using a prospectively maintained multi-institutional database, we compared baseline clinical characteristics and perioperative and postoperative outcomes, including pathological stage, tumor histology, operative time, ischemia time, estimated blood loss (EBL), length of stay (LOS), postoperative complication rate, recurrence rate, and mortality. We identified a total of 58 patients who had undergone robotic salvage surgery for a recurrent renal mass, of which 22 (38%) had sRRN and 36 (62%) had sRPN. Ischemia time for sRPN was 14 min. The median EBL was 100 mL in both groups (
p
= 0.581). One intraoperative complication occurred during sRRN, while three occurred during sRPN cases (
p
= 1.000). The median LOS was 2 days for sRRN and 1 day for sRPN (
p
= 0.039). Postoperatively, one major complication occurred after sRRN and two after sRPN (
p
= 1.000). The recurrence reported after sRRN was 5% and 3% after sRPN. Among the patients who underwent sRRN, the two most prevalent stages were pT1a (27%) and pT3a (27%). Similarly, the two most prevalent stages in sRPN patients were pT1a (69%) and pT3a (6%). sRRN and sRPN have similar operative and perioperative outcomes. sRPN is a safe and feasible procedure when performed by experienced surgeons. Future studies on large cohorts are essential to better characterize the importance and benefit of salvage partial nephrectomies. |
| doi_str_mv | 10.1007/s11701-023-01538-6 |
| format | Article |
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p
= 0.581). One intraoperative complication occurred during sRRN, while three occurred during sRPN cases (
p
= 1.000). The median LOS was 2 days for sRRN and 1 day for sRPN (
p
= 0.039). Postoperatively, one major complication occurred after sRRN and two after sRPN (
p
= 1.000). The recurrence reported after sRRN was 5% and 3% after sRPN. Among the patients who underwent sRRN, the two most prevalent stages were pT1a (27%) and pT3a (27%). Similarly, the two most prevalent stages in sRPN patients were pT1a (69%) and pT3a (6%). sRRN and sRPN have similar operative and perioperative outcomes. sRPN is a safe and feasible procedure when performed by experienced surgeons. Future studies on large cohorts are essential to better characterize the importance and benefit of salvage partial nephrectomies.</description><identifier>ISSN: 1863-2491</identifier><identifier>ISSN: 1863-2483</identifier><identifier>EISSN: 1863-2491</identifier><identifier>DOI: 10.1007/s11701-023-01538-6</identifier><identifier>PMID: 36928751</identifier><language>eng</language><publisher>London: Springer London</publisher><subject>Ablation ; Body mass index ; Comorbidity ; Diabetes ; Hispanic people ; Histology ; Humans ; Hypertension ; Ischemia ; Kidney Neoplasms - pathology ; Kidney Neoplasms - surgery ; Medical prognosis ; Medicine ; Medicine & Public Health ; Minimally Invasive Surgery ; Mortality ; Nephrectomy - adverse effects ; Nephrectomy - methods ; Postoperative period ; Retrospective Studies ; Robotic surgery ; Robotic Surgical Procedures - methods ; Surgeons ; Surgery ; Treatment Outcome ; Tumors ; Urology ; Variables</subject><ispartof>Journal of robotic surgery, 2023-08, Vol.17 (4), p.1579-1585</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-dcd165fa25e79f6f55b08c09da9b1bc1710c1dd431ff2c55ca71cf811b38e99a3</citedby><cites>FETCH-LOGICAL-c375t-dcd165fa25e79f6f55b08c09da9b1bc1710c1dd431ff2c55ca71cf811b38e99a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11701-023-01538-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2918717034?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,776,780,21367,27901,27902,33721,33722,41464,42533,43781,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36928751$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Okhawere, Kennedy E.</creatorcontrib><creatorcontrib>Grauer, Ralph</creatorcontrib><creatorcontrib>Zuluaga, Laura</creatorcontrib><creatorcontrib>Meilika, Kirolos N.</creatorcontrib><creatorcontrib>Ucpinar, Burak</creatorcontrib><creatorcontrib>Beksac, Alp Tuna</creatorcontrib><creatorcontrib>Razdan, Shirin</creatorcontrib><creatorcontrib>Saini, Indu</creatorcontrib><creatorcontrib>Abramowitz, Chiya</creatorcontrib><creatorcontrib>Abaza, Ronney</creatorcontrib><creatorcontrib>Eun, Daniel D.</creatorcontrib><creatorcontrib>Bhandari, Akshay</creatorcontrib><creatorcontrib>Hemal, Ashok K.</creatorcontrib><creatorcontrib>Porter, James</creatorcontrib><creatorcontrib>Stifelman, Michael D.</creatorcontrib><creatorcontrib>Menon, Mani</creatorcontrib><creatorcontrib>Badani, Ketan K.</creatorcontrib><title>Operative and oncological outcomes of salvage robotic radical and partial nephrectomy: a multicenter experience</title><title>Journal of robotic surgery</title><addtitle>J Robotic Surg</addtitle><addtitle>J Robot Surg</addtitle><description>We aim to describe the perioperative and oncological outcomes for salvage robotic partial nephrectomy (sRPN) and salvage robotic radical nephrectomy (sRRN). Using a prospectively maintained multi-institutional database, we compared baseline clinical characteristics and perioperative and postoperative outcomes, including pathological stage, tumor histology, operative time, ischemia time, estimated blood loss (EBL), length of stay (LOS), postoperative complication rate, recurrence rate, and mortality. We identified a total of 58 patients who had undergone robotic salvage surgery for a recurrent renal mass, of which 22 (38%) had sRRN and 36 (62%) had sRPN. Ischemia time for sRPN was 14 min. The median EBL was 100 mL in both groups (
p
= 0.581). One intraoperative complication occurred during sRRN, while three occurred during sRPN cases (
p
= 1.000). The median LOS was 2 days for sRRN and 1 day for sRPN (
p
= 0.039). Postoperatively, one major complication occurred after sRRN and two after sRPN (
p
= 1.000). The recurrence reported after sRRN was 5% and 3% after sRPN. Among the patients who underwent sRRN, the two most prevalent stages were pT1a (27%) and pT3a (27%). Similarly, the two most prevalent stages in sRPN patients were pT1a (69%) and pT3a (6%). sRRN and sRPN have similar operative and perioperative outcomes. sRPN is a safe and feasible procedure when performed by experienced surgeons. Future studies on large cohorts are essential to better characterize the importance and benefit of salvage partial nephrectomies.</description><subject>Ablation</subject><subject>Body mass index</subject><subject>Comorbidity</subject><subject>Diabetes</subject><subject>Hispanic people</subject><subject>Histology</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Ischemia</subject><subject>Kidney Neoplasms - pathology</subject><subject>Kidney Neoplasms - surgery</subject><subject>Medical prognosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Minimally Invasive Surgery</subject><subject>Mortality</subject><subject>Nephrectomy - adverse effects</subject><subject>Nephrectomy - methods</subject><subject>Postoperative period</subject><subject>Retrospective Studies</subject><subject>Robotic surgery</subject><subject>Robotic Surgical Procedures - methods</subject><subject>Surgeons</subject><subject>Surgery</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><subject>Urology</subject><subject>Variables</subject><issn>1863-2491</issn><issn>1863-2483</issn><issn>1863-2491</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kUtLxTAQhYMoPq7-ARcScOOmmmlumsadiC8Q3Og6pOnkWmmbmrSi_95cry9cuJqB-c6ZYQ4h-8COgTF5EgEkg4zlPGMgeJkVa2QbyoJn-VzB-q9-i-zE-MSYkILDJtnihcpLKWCb-LsBgxmbF6Smr6nvrW_9orGmpX4are8wUu9oNO2LWSANvvJjY2kw9Qez1AwmjE3qexweA9rRd2-n1NBuahOJ_YiB4mva0mBvcZdsONNG3PusM_JweXF_fp3d3l3dnJ_dZpZLMWa1raEQzuQCpXKFE6JipWWqNqqCyoIEZqGu5xycy60Q1kiwrgSoeIlKGT4jRyvfIfjnCeOouyZabFvTo5-izss5Z5yrVGbk8A_65KfQp-t0rqCU6cl8SeUrygYfY0Cnh9B0JrxpYHoZh17FoVMc-iMOXSTRwaf1VHVYf0u-_p8AvgJiGvULDD-7_7F9B6lIlz4</recordid><startdate>20230801</startdate><enddate>20230801</enddate><creator>Okhawere, Kennedy E.</creator><creator>Grauer, Ralph</creator><creator>Zuluaga, Laura</creator><creator>Meilika, Kirolos N.</creator><creator>Ucpinar, Burak</creator><creator>Beksac, Alp Tuna</creator><creator>Razdan, Shirin</creator><creator>Saini, Indu</creator><creator>Abramowitz, Chiya</creator><creator>Abaza, Ronney</creator><creator>Eun, Daniel D.</creator><creator>Bhandari, Akshay</creator><creator>Hemal, Ashok K.</creator><creator>Porter, James</creator><creator>Stifelman, Michael D.</creator><creator>Menon, Mani</creator><creator>Badani, Ketan K.</creator><general>Springer London</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FE</scope><scope>8FG</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>L6V</scope><scope>M0S</scope><scope>M7S</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>7X8</scope></search><sort><creationdate>20230801</creationdate><title>Operative and oncological outcomes of salvage robotic radical and partial nephrectomy: a multicenter experience</title><author>Okhawere, Kennedy E. ; Grauer, Ralph ; Zuluaga, Laura ; Meilika, Kirolos N. ; Ucpinar, Burak ; Beksac, Alp Tuna ; Razdan, Shirin ; Saini, Indu ; Abramowitz, Chiya ; Abaza, Ronney ; Eun, Daniel D. ; Bhandari, Akshay ; Hemal, Ashok K. ; Porter, James ; Stifelman, Michael D. ; Menon, Mani ; Badani, Ketan K.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-dcd165fa25e79f6f55b08c09da9b1bc1710c1dd431ff2c55ca71cf811b38e99a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Ablation</topic><topic>Body mass index</topic><topic>Comorbidity</topic><topic>Diabetes</topic><topic>Hispanic people</topic><topic>Histology</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Ischemia</topic><topic>Kidney Neoplasms - pathology</topic><topic>Kidney Neoplasms - surgery</topic><topic>Medical prognosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Minimally Invasive Surgery</topic><topic>Mortality</topic><topic>Nephrectomy - adverse effects</topic><topic>Nephrectomy - methods</topic><topic>Postoperative period</topic><topic>Retrospective Studies</topic><topic>Robotic surgery</topic><topic>Robotic Surgical Procedures - methods</topic><topic>Surgeons</topic><topic>Surgery</topic><topic>Treatment Outcome</topic><topic>Tumors</topic><topic>Urology</topic><topic>Variables</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Okhawere, Kennedy E.</creatorcontrib><creatorcontrib>Grauer, Ralph</creatorcontrib><creatorcontrib>Zuluaga, Laura</creatorcontrib><creatorcontrib>Meilika, Kirolos N.</creatorcontrib><creatorcontrib>Ucpinar, Burak</creatorcontrib><creatorcontrib>Beksac, Alp Tuna</creatorcontrib><creatorcontrib>Razdan, Shirin</creatorcontrib><creatorcontrib>Saini, Indu</creatorcontrib><creatorcontrib>Abramowitz, Chiya</creatorcontrib><creatorcontrib>Abaza, Ronney</creatorcontrib><creatorcontrib>Eun, Daniel D.</creatorcontrib><creatorcontrib>Bhandari, Akshay</creatorcontrib><creatorcontrib>Hemal, Ashok K.</creatorcontrib><creatorcontrib>Porter, James</creatorcontrib><creatorcontrib>Stifelman, Michael D.</creatorcontrib><creatorcontrib>Menon, Mani</creatorcontrib><creatorcontrib>Badani, Ketan K.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Health and Medical</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Engineering Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Engineering Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>Engineering Collection</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of robotic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Okhawere, Kennedy E.</au><au>Grauer, Ralph</au><au>Zuluaga, Laura</au><au>Meilika, Kirolos N.</au><au>Ucpinar, Burak</au><au>Beksac, Alp Tuna</au><au>Razdan, Shirin</au><au>Saini, Indu</au><au>Abramowitz, Chiya</au><au>Abaza, Ronney</au><au>Eun, Daniel D.</au><au>Bhandari, Akshay</au><au>Hemal, Ashok K.</au><au>Porter, James</au><au>Stifelman, Michael D.</au><au>Menon, Mani</au><au>Badani, Ketan K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Operative and oncological outcomes of salvage robotic radical and partial nephrectomy: a multicenter experience</atitle><jtitle>Journal of robotic surgery</jtitle><stitle>J Robotic Surg</stitle><addtitle>J Robot Surg</addtitle><date>2023-08-01</date><risdate>2023</risdate><volume>17</volume><issue>4</issue><spage>1579</spage><epage>1585</epage><pages>1579-1585</pages><issn>1863-2491</issn><issn>1863-2483</issn><eissn>1863-2491</eissn><abstract>We aim to describe the perioperative and oncological outcomes for salvage robotic partial nephrectomy (sRPN) and salvage robotic radical nephrectomy (sRRN). Using a prospectively maintained multi-institutional database, we compared baseline clinical characteristics and perioperative and postoperative outcomes, including pathological stage, tumor histology, operative time, ischemia time, estimated blood loss (EBL), length of stay (LOS), postoperative complication rate, recurrence rate, and mortality. We identified a total of 58 patients who had undergone robotic salvage surgery for a recurrent renal mass, of which 22 (38%) had sRRN and 36 (62%) had sRPN. Ischemia time for sRPN was 14 min. The median EBL was 100 mL in both groups (
p
= 0.581). One intraoperative complication occurred during sRRN, while three occurred during sRPN cases (
p
= 1.000). The median LOS was 2 days for sRRN and 1 day for sRPN (
p
= 0.039). Postoperatively, one major complication occurred after sRRN and two after sRPN (
p
= 1.000). The recurrence reported after sRRN was 5% and 3% after sRPN. Among the patients who underwent sRRN, the two most prevalent stages were pT1a (27%) and pT3a (27%). Similarly, the two most prevalent stages in sRPN patients were pT1a (69%) and pT3a (6%). sRRN and sRPN have similar operative and perioperative outcomes. sRPN is a safe and feasible procedure when performed by experienced surgeons. Future studies on large cohorts are essential to better characterize the importance and benefit of salvage partial nephrectomies.</abstract><cop>London</cop><pub>Springer London</pub><pmid>36928751</pmid><doi>10.1007/s11701-023-01538-6</doi><tpages>7</tpages></addata></record> |
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| subjects | Ablation Body mass index Comorbidity Diabetes Hispanic people Histology Humans Hypertension Ischemia Kidney Neoplasms - pathology Kidney Neoplasms - surgery Medical prognosis Medicine Medicine & Public Health Minimally Invasive Surgery Mortality Nephrectomy - adverse effects Nephrectomy - methods Postoperative period Retrospective Studies Robotic surgery Robotic Surgical Procedures - methods Surgeons Surgery Treatment Outcome Tumors Urology Variables |
| title | Operative and oncological outcomes of salvage robotic radical and partial nephrectomy: a multicenter experience |
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