Comparison of parenchymal volume loss assessed by three‐dimensional computed tomography volumetry and renal functional recovery between conventional and robot‐assisted laparoscopic partial nephrectomy. Issue 1 (5th July 2021)

• Record Type: Journal Article
• Authors: Kanda, Sohei; Inoue, Takamitsu; Nakajima, Shiori; Sagehashi, Ryuichiro; Nara, Taketoshi; Numakura, Kazuyuki; Saito, Mitsuru; Narita, Shintaro; Tsuchiya, Norihiko; Habuchi, Tomonori
• Is Part Of: Asian journal of endoscopic surgery. Volume 15:Issue 1(2022)
• Page Start: 63
• Page End: 69
• Publication Date: 2021-07-05
• Subjects: partial nephrectomy -- robotic surgery -- volumetric analysis; Endoscopic surgery -- Periodicals; Endoscopic surgery -- Asia -- Periodicals; 617.05705
• DOI: 10.1111/ases.12966
• Languages: English
• ISSNs: 1758-5902

Abstract

Abstract: Objectives: We retrospectively investigated if robot‐assisted laparoscopic partial nephrectomy (RAPN) contributes to a decrease in resected parenchymal volume (RPV), an increase in postoperative parenchymal volume (PPV), and an improvement of postoperative renal function when compared with conventional laparoscopic partial nephrectomy (LPN) using a three‐dimensional image analysis system. Methods: Patients who underwent LPN (n = 37) and RAPN (n = 66) from November 2013 to November 2018 were included in this study. All patients had a tumor diameter of 4 cm or less. Patients with an anatomical or functional single kidney were excluded. RPV and PPV were measured using SYNAPSE VINCENT®. The surgical outcomes were compared between the two groups. Results: Warm ischemic time in the RAPN group was significantly shorter than that in the LPN group ( p < 0.001). The ratio of RPV to tumor volume (RPV/TV) in the RAPN group was significantly lower than that in the LPN group ( p = 0.016). PPV in the RAPN group was significantly higher than that in the LPN group ( p = 0.049). The decreased estimated glomerular filtration rate in the RAPN group was significantly lower than that in the LPN group on days 1, 7, 30, 90, and 180 after surgery. Conclusions: Postoperative renal function in the RAPN group was significantly better than that in the LPN group in both the short and long term. In addition to a short warm ischemia time, the decreased RPV/TV and increased PPV may have contributed to the improvement of postoperative renal function.