Open versus robot-assisted partial nephrectomy: A longitudinal comparison of 880 patients over 10 years.
minimally invasive surgery
nephrectomy
partial robot-assisted partial nephrectomy
renal cell carcinoma
Journal
The international journal of medical robotics + computer assisted surgery : MRCAS
ISSN: 1478-596X
Titre abrégé: Int J Med Robot
Pays: England
ID NLM: 101250764
Informations de publication
Date de publication:
Feb 2021
Feb 2021
Historique:
received:
04
07
2020
revised:
26
08
2020
accepted:
10
09
2020
pubmed:
14
9
2020
medline:
19
8
2021
entrez:
13
9
2020
Statut:
ppublish
Résumé
Most comparisons between robot-assisted partial nephrectomy (RAPN) and open partial nephrectomy (OPN) indicate the superiority of RAPN, but the learning curve is often not considered. All consecutive partial nephrectomies from the very first RAPN at a single tertiary referral centre (n = 818, 500 RAPN vs. 313 OPN) were retrospectively analyzed. Complications, success rates and surgical outcomes were compared. Inequalities between cohorts and the inherent learning curve were controlled by subgroup comparisons, regression analyses, and propensity score matching. Overall, RAPN had fewer complications, less blood loss, and shorter length of stay. However, an inherent learning curve caused higher complications for the first 4 years. Thereafter, perioperative outcomes clearly favoured RAPN, even for more complex tumours. In one of the largest monocentric cohorts over more than 10 years, RAPN was found to be superior to OPN. However, not all advantages of RAPN are immediate because a learning curve must be passed.
Sections du résumé
BACKGROUND
BACKGROUND
Most comparisons between robot-assisted partial nephrectomy (RAPN) and open partial nephrectomy (OPN) indicate the superiority of RAPN, but the learning curve is often not considered.
METHODS
METHODS
All consecutive partial nephrectomies from the very first RAPN at a single tertiary referral centre (n = 818, 500 RAPN vs. 313 OPN) were retrospectively analyzed. Complications, success rates and surgical outcomes were compared. Inequalities between cohorts and the inherent learning curve were controlled by subgroup comparisons, regression analyses, and propensity score matching.
RESULTS
RESULTS
Overall, RAPN had fewer complications, less blood loss, and shorter length of stay. However, an inherent learning curve caused higher complications for the first 4 years. Thereafter, perioperative outcomes clearly favoured RAPN, even for more complex tumours.
CONCLUSIONS
CONCLUSIONS
In one of the largest monocentric cohorts over more than 10 years, RAPN was found to be superior to OPN. However, not all advantages of RAPN are immediate because a learning curve must be passed.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1-8Subventions
Organisme : Open access funding enabled and organized by Projekt DEAL
Informations de copyright
© 2020 The Authors. The International Journal of Medical Robotics and Computer Assisted Surgery published by John Wiley & Sons Ltd.