A Comparison of Surgical and Functional Outcomes of Robot-Assisted Versus Pure Laparoscopic Partial

Background and Objectives: Robot-assisted partial ne-phrectomy (RAPN) is emerging as an alternative to lapa-roscopic partial nephrectomy (LPN) for the treatment of small renal tumors. We compare the results of LPN and RAPN performed by a single surgeon. Methods: Data from 100 consecutive patients who under-went LPN (n52) or RAPN (n48) performed by a single experienced laparoscopic surgeon between October 2007 and June 2010 were analyzed retrospectively. Perioperative data, including clinical, pathological, and functional out-comes, were compared between the LPN and RAPN groups. Results: No significant differences were found between groups with regard to mean estimated blood loss, main operation time, warm ischemic time, intraoperative com-plications, postoperative complications, hospital stay, or percent reduction of hemoglobin. The mean duration of follow-up was 16.2 months for LPN patients versus 8.9 months for RAPN patients (P.001). With respect to the clamping method, more artery-only clamping occurred during RAPN than LPN (38.5 vs 75%, respectively, P.001). The mean pathological tumor volume for LPN was 4.0 cm3 vs 8.2 cm3 for RAPN (P.006). The mean resected healthy tissue volume was 25.1 cm3 for LPN versus 16.1 cm3 for RAPN (P.044). There were no sig-nificant differences in positive margins or changes in renal function between the 2 cohorts. Conclusion: RAPN is a comparable and alternative op-tion to LPN, providing equivalent oncological and func-tional outcomes, as well as comparable morbidity to LPN. Although RAPN could offer the advantages of saving more healthy marginal tissue, longer-term and larger studies are necessary to evaluate the functional advantages