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Long-term outcomes of minimally invasive surgeries in partial nephrectomy. Robot or laparoscopy?
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  • Mehmet Salih Boga,
  • Mehmet Giray Sozmez,
  • Kaan Karamık,
  • Cagatay Ozsoy,
  • Arif Aydin,
  • Murat Savas,
  • Mutlu Ates
Mehmet Salih Boga
University of Health Sciences Antalya Training and Research Hospital
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Mehmet Giray Sozmez
Necmettin Erbakan University Meram Medical Faculty Hospital
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Kaan Karamık
Antalya Training and Research Hospital
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Cagatay Ozsoy
Antalya Training and Research Hospital
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Arif Aydin
Necmettin Erbakan University Meram Medical Faculty Hospital
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Murat Savas
Antalya Training and Research Hospital
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Mutlu Ates
Antalya Training and Research Hospital
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Abstract

Background: To compare long-term oncological and renal functional outcomes of laparoscopic and robotic partial nephrectomy for small renal masses. Methods: A total of 103 patients who underwent laparoscopic (n= 31) and robotic (n= 72) partial nephrectomy between April 2015 and November 2018 were included in the study. Perioperative parameters, long-term oncological and functional outcomes were compared between the laparoscopic and robotic groups. Results: No significant differences were found in terms of age, tumor size, RENAL and PADUA scores, preoperative estimated glomerular filtration rate (eGFR), and presence of chronic hypertension and diabetes (p=0.479, p=0.199, p=0.120 and p=0.073, p=0.561 and p=0.082 and p=0.518, respectively). Only estimated blood loss was significantly higher in the laparoscopic group in operative parameters (158.23±72.24 mL vs 121.11±72.17 mL; P=0.019), but transfusion rates were similar between the groups (p=0.33). In the laparoscopic group, two patients (6.5%) required conversion to open, while no conversion was needed in the robotic group (p=0.89). There were no differences in terms of positive surgical margin and complication rates (p=0.636 and p=0.829, respectively). No significant differences were observed in eGFR changes and postoperative new-onset chronic kidney disease at one year after the operation (p=0.768, p=0.614, respectively). The overall mean follow- up period was 36.07±13.56 months (p=0.007). During the follow-up period, no cancer-related death observed in both group and non-cancer specific survival was 93.5% and 94.4% in laparoscopic and robotic groups, respectively (p=0.859). Conclusions: In this study, perioperative and long-term oncological and functional outcomes seems to be comparable between laparoscopic and robotic partial nephrectomies.

Peer review status:UNDER REVIEW

03 Aug 2020Submitted to International Journal of Clinical Practice
04 Aug 2020Submission Checks Completed
04 Aug 2020Assigned to Editor
13 Aug 2020Reviewer(s) Assigned
31 Aug 2020Review(s) Completed, Editorial Evaluation Pending
24 Sep 20201st Revision Received
25 Sep 2020Submission Checks Completed
25 Sep 2020Assigned to Editor
25 Sep 2020Reviewer(s) Assigned