Robot-assisted partial nephrectomy is associated with early recovery of renal function: Comparison of open, laparoscopic, and robot-assisted partial nephrectomy using DTPA renal scintigraphy

Abstract

ObjectivesTo compare the functional outcomes of open, laparoscopic, and robot-assisted partial nephrectomy (OPN, LPN, and RAPN, respectively) using diethylene triamine penta-acetic acid (DTPA). MethodsWe identified 610 patients who underwent partial nephrectomy for renal cell carcinoma (285 open partial nephrectomy [OPN], 96 laparoscopic partial nephrectomy [LPN], and 229 robot-assisted partial nephrectomy [RAPN]) with preoperative and postoperative DTPA within 1 year. We excluded multiple renal masses and history of immunotherapy or chemotherapy. Predictive factors for glomerular filtration rate (GFR) reduction were assessed using multivariate linear regression. ResultsPostoperative complications and disease-free survival were similar in the three groups. Within 1 postoperative year, OPN showed a significantly lower mean ipsilateral GFR than LPN and RAPN (28.9 versus 32.4 versus 32.7mL/min/1.73m (2), respectively; P<0.001). RAPN was associated with a significantly higher total GFR than OPN within 1 year (76.6 versus 71.2mL/min/1.73m (2), respectively; P=0.001). On multivariate analysis within 1 year, operation type (OPN versus RAPN: beta=2.82; 95% confidence interval, 1.17-4.48; P=0.001) was significantly associated with GFR reduction. ConclusionThere was no difference in postoperative complications and disease-free survival among operation types. RAPN could help to promote earlier recovery of ipsilateral GFR than OPN.