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Robotic partial nephrectomy for completely endophytic renal tumors: complications and functional and oncologic outcomes during a 4-year median period of follow-up.

 Christos Komninos  ;  Tae Young Shin  ;  Patrick Tuliao  ;  Dae Keun Kim  ;  Woong Kyu Han  ;  Byung Ha Chung  ;  Young Deuk Choi  ;  Koon Ho Rha 
 UROLOGY, Vol.84(6) : 1367-1373, 2014 
Journal Title
Issue Date
Adult ; Carcinoma, Renal Cell/mortality ; Carcinoma, Renal Cell/pathology* ; Carcinoma, Renal Cell/surgery* ; Cohort Studies ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Kidney Neoplasms/mortality ; Kidney Neoplasms/pathology* ; Kidney Neoplasms/surgery* ; Laparoscopy/adverse effects ; Laparoscopy/methods ; Male ; Middle Aged ; Nephrectomy/adverse effects ; Nephrectomy/methods* ; Postoperative Complications/mortality ; Postoperative Complications/physiopathology ; Retrospective Studies ; Risk Assessment ; Robotics/methods* ; Survival Rate ; Time Factors ; Treatment Outcome
OBJECTIVE: To evaluate the renal functional outcome, the oncologic safety, and the occurrence of complications after robotic-assisted laparoscopic partial nephrectomy (RPN) for completely endophytic tumors.
MATERIAL AND METHODS: Data of 45 patients with completely endophytic tumors, 116 patients with mesophytic, and 64 patients with exophytic masses who underwent RPN were retrospectively analyzed. Perioperative, oncologic, and functional data were evaluated and analyzed with SPSS, version 18.
RESULTS: Demographic characteristics were similar among the groups. The median follow-up of the endophytic, the mesophytic, and the exophytic groups were 48, 43, and 38 months, respectively. Endophytic masses were more likely to be malignant and have a higher overall tumor complexity, estimated by the RENAL score (9 vs 8 vs 5.5; P <.01; P = .02). We did not detect any statistically significant differences among the groups regarding blood loss volume, transfusion rates, length of stay, and intraoperative and postoperative complications (P = .49, .25, .87, .42, and .20, respectively). There was a statistically significant difference in the estimated glomerular filtration rate percentage change on the first postoperative day (P = .02), but this significance was not observed after the first week. The patients in the endophytic group showed a tendency toward increased rates of positive surgical margins compared with the mesophytic and exophytic groups (P = .06). However, there were not any significant differences regarding the recurrence-free survival rates (P = .335) and the overall mortality rates (P = .570) according to the Kaplan-Meier analysis.
CONCLUSION: In experienced institutes, RPN for entirely intraparenchymal masses is a feasible procedure in terms of complication rates, functional and oncologic outcomes during an intermediate-term period of follow-up.
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1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dae Keun(김대근)
Rha, Koon Ho(나군호) ORCID logo https://orcid.org/0000-0001-8588-7584
Shin, Tae Young(신태영)
Chung, Byung Ha(정병하) ORCID logo https://orcid.org/0000-0001-9817-3660
Choi, Young Deuk(최영득) ORCID logo https://orcid.org/0000-0002-8545-5797
Komninos, Christos(크리스토스콤니노스)
Tuliao, Patrick(툴리아오패트릭)
Han, Woong Kyu(한웅규) ORCID logo https://orcid.org/0000-0002-2527-4046
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