Prospective study of robotic partial nephrectomy for renal cancer in Japan: Comparison with a historical control undergoing laparoscopic partial nephrectomy

To evaluate the outcomes of robotic partial nephrectomy compared with those of laparoscopic partial nephrectomy for T1 renal tumors in Japanese centers.

Patients with a T1 renal tumor who underwent robotic partial nephrectomy were eligible for inclusion in the present study. The primary end-point consisted of three components: a negative surgical margin, no conversion to open or laparoscopic surgery and a warm ischemia time ≤25 min. We compared data from these patients with the data from a retrospective study of laparoscopic partial nephrectomy carried out in Japan.

A total of 108 patients were registered in the present study; 105 underwent robotic partial nephrectomy. The proportion of patients who met the primary end-point was 91.3% (95% confidence interval 84.1-95.9%), which was significantly higher than 23.3% in the historical data. Major complications were seen in 19 patients (18.1%). The mean change in the estimated glomerular filtration rate in the operated kidney, 180 days postoperatively, was -10.8 mL/min/1.73 m2 (95% confidence interval -12.3-9.4%).

Robotic partial nephrectomy for patients with a T1 renal tumor is a safe, feasible and more effective operative method compared with laparoscopic partial nephrectomy. It can be anticipated that robotic partial nephrectomy will become more widely used in Japan in the future.

International journal of urology : official journal of the Japanese Urological Association. 2018 Apr 19 [Epub ahead of print]

Kazushi Tanaka, Jun Teishima, Atsushi Takenaka, Ryoichi Shiroki, Yasuyuki Kobayashi, Kazunori Hattori, Hiro-Omi Kanayama, Shigeo Horie, Yasushi Yoshino, Masato Fujisawa

Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan., Department of Urology, Institute of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan., Division of Urology, Tottori University, Yonago, Japan., Department of Urology, Fujita Health University, Toyoake, Japan., Department of Urology, Okayama University Graduate School of Medicine, Okayama, Japan., Department of Urology, St. Luke's International Hospital, Tokyo, Japan., Department of Urology, Tokushima University Graduate School, Tokushima, Japan., Department of Urology, Juntendo University, Tokyo, Japan., Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan.