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Robotic versus laparoscopic radical nephrectomy: a large multi-institutional analysis (ROSULA Collaborative Group)

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dc.contributor.author나군호-
dc.date.accessioned2020-02-11T06:04:53Z-
dc.date.available2020-02-11T06:04:53Z-
dc.date.issued2019-
dc.identifier.issn0724-4983-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/174525-
dc.description.abstractOBJECTIVE: To compare the outcomes of robotic radical nephrectomy (RRN) to those of laparoscopic radical nephrectomy (LRN) for large renal masses. METHODS: This was a retrospective analysis of RRN and LRN cases performed for large (≥ cT2) renal masses from 2004 to 2017 and collected in the multi-institutional international database (ROSULA: RObotic SUrgery for LArge renal masses). Peri-operative, functional, and oncologic outcomes were compared between each approach. Descriptive analyses were performed and presented as medians with interquartile ranges. Inverse probability of treatment weighting-adjusted multivariable analyses were used to identify predictors of peri-operative complications. Kaplan-Meier analysis and Cox regression models were used to assess survival outcomes. RESULTS: A total of 941 patients (RRN = 404, LRN = 537) were identified. There was no difference in terms of gender, age, and clinical tumor size. Over the study period, RRN had an annual increase of 11.75% (95% CI [7.34, 17.01] p < 0.001) and LRN had an annual decline of 5.39% (95% CI [-6.94, -3.86] p < 0.001). Patients undergoing RRN had higher BMI (27.6 [IQR 24.8-31.1] vs. 26.5 [24.1-30.0] kg/m2, p < 0.01). Operative duration was longer for RRN (185.0 [150.0-237.2] vs. 126 [90.8-180.0] min, p < 0.001). Length of stay was shorter for RRN (3.0 [2.0-4.0] vs. 5.0 [4.0-7.0] days, p < 0.001). RRN cases presented more advanced disease (higher pathologic staging [pT3-4 52.5 vs. 24.2%, p < 0.001], histologic grade [high grade 49.3 vs. 30.4%, p < 0.001], and rate of nodal disease [pN1 5.4 vs. 1.9%, p < 0.01]). Surgical approach did not represent an independent risk factor for peri-operative complications (OR 1.81 95% CI [0.97-3.39], adjusted p = 0.2). The main study limitation is the retrospective design. CONCLUSIONS: This study represents the largest known multi-center comparison between RRN and LRN. The two procedures seem to offer similar peri-operative outcomes. Notably, RRN has been increasingly utilized, especially in the setting of more advanced and surgically challenging disease without increasing the risk of peri-operative complications.-
dc.description.statementOfResponsibilityrestriction-
dc.languageEnglish-
dc.publisherSpringer International-
dc.relation.isPartOfWORLD JOURNAL OF UROLOGY-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.titleRobotic versus laparoscopic radical nephrectomy: a large multi-institutional analysis (ROSULA Collaborative Group)-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Urology (비뇨의학교실)-
dc.contributor.googleauthorUzoma A. Anele-
dc.contributor.googleauthorMichele Marchioni-
dc.contributor.googleauthorBo Yang-
dc.contributor.googleauthorGiuseppe Simone-
dc.contributor.googleauthorRobert G. Uzzo-
dc.contributor.googleauthorClayton Lau-
dc.contributor.googleauthorMaria C. Mir-
dc.contributor.googleauthorUmberto Capitanio-
dc.contributor.googleauthorJames Porter-
dc.contributor.googleauthorKen Jacobsohn-
dc.contributor.googleauthorNicolo de Luyk-
dc.contributor.googleauthorAndrea Mari-
dc.contributor.googleauthorKidon Chang-
dc.contributor.googleauthorCristian Fiori-
dc.contributor.googleauthorJay Sulek-
dc.contributor.googleauthorAlexandre Mottrie-
dc.contributor.googleauthorWesley White-
dc.contributor.googleauthorSisto Perdona-
dc.contributor.googleauthorGiuseppe Quarto-
dc.contributor.googleauthorAhmet Bindayi-
dc.contributor.googleauthorAkbar Ashrafi-
dc.contributor.googleauthorLuigi Schips-
dc.contributor.googleauthorFrancesco Berardinelli-
dc.contributor.googleauthorChao Zhang-
dc.contributor.googleauthorMichele Gallucci-
dc.contributor.googleauthorMiguel Ramirez-Backhaus-
dc.contributor.googleauthorAlessandro Larcher-
dc.contributor.googleauthorPatrick Kilday-
dc.contributor.googleauthorMichael Liao-
dc.contributor.googleauthorPeter Langenstroer-
dc.contributor.googleauthorProkar Dasgupta-
dc.contributor.googleauthorBen Challacombe-
dc.contributor.googleauthorAlexander Kutikov-
dc.contributor.googleauthorAndrea Minervini-
dc.contributor.googleauthorKoon Ho Rha-
dc.contributor.googleauthorChandru P. Sundaram-
dc.contributor.googleauthorLance J. Hampton-
dc.contributor.googleauthorFrancesco Porpiglia-
dc.contributor.googleauthorMonish Aron-
dc.contributor.googleauthorIthaar Derweesh-
dc.contributor.googleauthorRiccardo Autorino-
dc.identifier.doi10.1007/s00345-019-02657-2-
dc.contributor.localIdA01227-
dc.relation.journalcodeJ02805-
dc.identifier.eissn1433-8726-
dc.identifier.pmid30734072-
dc.identifier.urlhttps://link.springer.com/article/10.1007%2Fs00345-019-02657-2-
dc.subject.keywordComparative outcomes-
dc.subject.keywordComplications-
dc.subject.keywordLaparoscopic-
dc.subject.keywordRadical nephrectomy-
dc.subject.keywordRobotic-
dc.contributor.alternativeNameRha, Koon Ho-
dc.contributor.affiliatedAuthor나군호-
dc.citation.volume37-
dc.citation.number11-
dc.citation.startPage2439-
dc.citation.endPage2450-
dc.identifier.bibliographicCitationWORLD JOURNAL OF UROLOGY, Vol.37(11) : 2439-2450, 2019-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers

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