Robotic partial nephrectomy : where do we stand? An Australian single centre experience

1. No. 186 Robotic partial nephrectomy : where do we stand? An Australian single centre experience Sam Chopra 1, Francis Ting, Carlo Yuen, Phillip Brenner Department of Urology, St. Vincent’s Hospital, Sydney Posters Proudly Supported by: Results A total of 20 patients underwent RPN during the study period, with a mean age of 64 years (36-78). MOT was 209 minutes (90-365) and average WIT was 16.6 minutes (8-30). The mean estimated blood loss was 182mL (50-1000), the average tumour size was 3cm (1.4-5.5). There was no conversion to open or laparoscopic surgery. Histology results were renal cell carcinoma (RCC) in 16 patients (80%) and benign lesions in 4 patients (20%). All Renal Cell carcinoma surgical margins were clear. There were no significant difference for median percent change in Serum Creatinine, 0 mg/dl (-31 to 215), and eGFR, -1 (-74 to 53), at discharge. Introduction Nephron sparing surgery (NSS) remains the standard of care for small renal masses (≤ 4cm). Robotic partial nephrectomy (RPN) has shown to be a safe and efficacious alternative to laparoscopic partial nephrectomy (LPN) in minimally invasive NSS (1). It offers the advantages of a laparoscopic access while minimizing the technical difficulty and reducing warm ischaemia time. Aim Primary aims of our study, is to present prospectively collected operative and oncological outcomes from men who underwent RPN at our institution. • Methods • We collected data on all men who underwent Robotic partial nephrectomy at our centre between November 2010 and January 2013. • Key recorded parameters included warm ischemia time (WIT), estimated blood loss (EBL), mean operative time (MOT), pre and post-operative creatinine, estimated glomerular filtration rate (eGFR), length of stay, positive margins, and conversion-to-open surgery. • We used the Clavien system for grading complications. References 1. Aboumarzouk OM, Stein RJ, Eyraud R, Haber GP, Chlosta PL, Somani BK, Kaouk JH. Robotic Versus Laparoscopic Partial Nephrectomy: A Systematic Review and Meta-Analysis. Eur Urol. 2012 Jun 27. [Epub ahead of print] Conclusions Our experience with RPN is similar to other centres of excellence around the world; we have been able to successfully perform Nephron sparing surgery with appropriately selected patients and with a significant reduction in WIT and blood loss. We believe that further studies of the long-term renal functional outcomes and oncological efficacy of RPN are needed before fully advocating this technique. Acknowledgements