Evaluation of laparoscopic vs robotic partial nephrectomy using the margin, ischemia and complications score system: a retrospective single center analysis


Published: March 31, 2015
Abstract Views: 15566
PDF: 1385
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

  • Stefano Ricciardulli Department of Urology, Chinese PLA General Hospital, Beijing, China; Department of Urology, San Bassiano Hospital, Bassano Del Grappa, Italy.
  • Qiang Ding Department of Urology, Chinese PLA General Hospital, Beijing, China.
  • Xu Zhang Department of Urology, Chinese PLA General Hospital, Beijing, China.
  • Hongzhao Li Department of Urology, Chinese PLA General Hospital, Beijing, China.
  • Yuzhe Tang Department of Urology, Chinese PLA General Hospital, Beijing, China.
  • Guoqiang Yang Department of Urology, Chinese PLA General Hospital, Beijing, China.
  • Xiyou Wang Department of Urology, Chinese PLA General Hospital, Beijing, China.
  • Xin Ma Department of Urology, Chinese PLA General Hospital, Beijing, China.
  • Alberto Breda Department of Urology, Foundacio Puigvert Universidad Autonoma de Barcelona, Spain.
  • Antonio Celia Department of Urology, San Bassiano Hospital, Bassano Del Grappa, Italy.
Objective: To evaluate differences between Laparoscopic Partial Nephrectomy (LPN) and Robot-Assisted Partial Nephrectomy (RAPN) using the Margin, Ischemia and Complications (MIC) score system and to evaluate factors related with MIC success. Materials and Methods: Single centre retrospective study on 258 LPN and 58 RAPN performed between January 2012 and January 2014. Success was defined when surgical margins was negative, Warm Ischemia Time (WIT) was ≤ 20 minutes and no major complications occurred. Mann-Whitney-U and Pearson χ2 correlation were used to compare LPN and RAPN. A matched pair comparison was also performed. Spearman correlation (Rho) was used to evaluate the relationship between clinical, intra and post-operative and pathological patients characteristics with MIC score. A binary regression analysis was also performed to evaluate independent factors associated with MIC success. Results: The MIC rate in LPN and RAPN was 55% and 65.5% respectively. No differences in clinical, intra and post-operative outcomes between groups were found. Clinical tumor size (p-value: < 0.001; OR: 0.829; 95% CI: 0.697-0.987), PADUA score (p-value: < 0.001; OR: 0.843; 95% CI: 0.740-0.960), PADUA risk groups (intermediate; p-value: < 0.001; OR: 0.416; 95% CI: 0.238- 0.792; high: p-value: < 0.001; OR: 0.356; 95% CI: 0.199- 0.636), WIT (p-value: < 0.001; OR: 0.598; 95% CI: 0.530- 0.675) were independently associated with MIC. eGFR (< 60 vs ≥ 60 ml/min per 1.73 m2: p-value: < 0.001; OR: 3.356; 95% CI: 1.701-6.621) and Fuhrman nuclear grade (p-value: 0.014; OR: 1.798; 95% CI:1.129-2.865) were also independently associated with MIC. Conclusions: MIC score system is a simple and useful tool to report and to compare different surgical approach.

Ricciardulli, S., Ding, Q., Zhang, X., Li, H., Tang, Y., Yang, G., Wang, X., Ma, X., Breda, A., & Celia, A. (2015). Evaluation of laparoscopic vs robotic partial nephrectomy using the margin, ischemia and complications score system: a retrospective single center analysis. Archivio Italiano Di Urologia E Andrologia, 87(1), 49–55. https://doi.org/10.4081/aiua.2015.1.49

Downloads

Download data is not yet available.

Citations