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, tumour size, RENAL and PADUA scores, pre‐operative estimated glomerular filtration rate (eGFR), and presence of chronic hypertension and diabetes (P =.479, P =.199, P =.120 and P =.073, P =.561, and P =.082 and P =.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 =.019), but transfusion rates were similar between the groups (P =.33). In the laparoscopic group, two patients (6.5%) required conversion to open, while no conversion was needed in the robotic group (P =.89). There were no differences in terms of positive surgical margin and complication rates (P =.636 and P =.829, respectively). No significant differences were observed in eGFR changes and post‐operative new‐onset chronic kidney disease at 1 year after the surgery (P =.768, P =.614, respectively). The overall mean follow‐up period was 36.07 ± 13.56 months (P =.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 =.859). Conclusions: In this study, perioperative and long‐term oncological and functional outcomes seems to be comparable between laparoscopic and robotic partial nephrectomies. [ABSTRACT FROM AUTHOR]