In:
Urologia Internationalis, S. Karger AG, Vol. 105, No. 5-6 ( 2021), p. 490-498
Abstract:
〈 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.
Type of Medium:
Online Resource
ISSN:
0042-1138
,
1423-0399
Language:
English
Publisher:
S. Karger AG
Publication Date:
2021
detail.hit.zdb_id:
1464417-4
