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Omission of Cortical Renorrhaphy During Robotic Partial Nephrectomy: A Vattikuti Collective Quality Initiative Database Analysis

 Sohrab Arora  ;  Chandler Bronkema  ;  James R Porter  ;  Alexander Mottrie  ;  Prokar Dasgupta  ;  Benjamin Challacombe  ;  Koon H Rha  ;  Rajesh K Ahlawat  ;  Umberto Capitanio  ;  Thyavihally B Yuvaraja  ;  Sudhir Rawal  ;  Daniel A Moon  ;  Ananthakrishnan Sivaraman  ;  Kris K Maes  ;  Fansesco Porpiglia  ;  Gagan Gautam  ;  Levent Turkeri  ;  Mahendra Bhandari  ;  Wooju Jeong  ;  Mani Menon  ;  Craig G Rogers  ;  Firas Abdollah 
 UROLOGY, Vol.146 : 125-132, 2020-12 
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Objectives: To analyze the outcomes of patients in whom cortical (outer) renorrhaphy (CR) was omitted during robotic partial nephrectomy (RPN).

Methods: We analyzed 1453 patients undergoing RPN, from 2006 to 2018, within a large multi-institutional database. Patients having surgery for bilateral tumors (n = 73) were excluded. CR and no-CR groups were compared in terms of operative and ischemia time, estimated blood loss (EBL), complications, surgical margins, hospital stay, change in estimated glomerular filtration rate (eGFR), and need of angioembolization. Inverse probability of treatment weighting with Firth correction for center code was performed to account for selection bias.

Results: CR was omitted in 120 patients (8.7%); 1260 (91.3%) patients underwent both inner layer and CR. There was no difference in intraoperative complications (7.4% CR; 8.9% no-CR group; P = .6), postoperative major complications (1% and 2.8% in CR and no-CR groups, respectively; P = .2), or median drop in eGFR (7.3 vs 10.4 mL/min/m2). The no-CR group had a higher incidence of minor complications (26.7% vs 5.5% in CR group; P < .001). EBL was 100 mL (IQR 50-200) in both groups (P = .6). Angioembolization was needed in 0.7% patients in CR vs 1.4% in no-CR group (P = .4). Additionally, there was no difference in median operative time (168 vs 162 min; P = .2) or ischemia time (18 vs 17 min; P = .7).

Conclusion: In selected patients with renal masses, single layer renorrhaphy does not significantly improve operative time, ischemia time, or eGFR after RPN. There is a higher incidence of minor complications, but not major perioperative complications after no-CR technique.
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1. College of Medicine (의과대학) > Dept. of Otorhinolaryngology (이비인후과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Rha, Koon Ho(나군호) ORCID logo https://orcid.org/0000-0001-8588-7584
Lim, Jae Yol(임재열) ORCID logo https://orcid.org/0000-0002-9757-6414
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