Long-term outcomes of minimally invasive surgeries in partial nephrectomy. Robot or laparoscopy?

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 surgery (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.