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

  • Stefano Ricciardulli | stefano.ricciardulli@gmail.com 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.

Abstract

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.

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Published
2015-03-31
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Section
Original Papers - Andrology
Keywords:
Complications, Laparoscopic partial nephrectomy, Positive margins, Robot-assisted partial nephrectomy, Warm ischemia time
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How to Cite
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

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