This retrospective study included prospectively maintained data from an institutional database and was approved by our institutional review board.
Therefore, this study aimed to evaluate the surgical and functional outcomes of cortical-renorrhaphy-omitting RAPN (CRO-RAPN) in comparison to those of cortical-renorrhaphy-omitting LPN (CRO-LPN). However, these advantages of RAPN compared to LPN are limited only among the conventional double-layer renorrhaphy technique. Previous studies have indicated that RAPN is more favorable than LPN in terms of renal functional preservation outcomes, shorter duration of hospital stay, and shorter warm ischemia time 13, 14, 15. However, the optimal platform to safely perform this challenging procedure has not been established. Furthermore, the omission of a cortical suture layer represented an ideal approach to reduce complication risk and preserve healthy renal parenchyma 5, 9, 10, 11, 12. While a consensus regarding the optimal renorrhaphy technique for postoperative renal function preservation has not yet been established, the single-layer renorrhaphy technique has been favorably considered for postoperative renal function compared to the double-layer technique 7, 8. In recent years, concerns with excessive renorrhaphy have emerged since an injured vascularized parenchyma prevents the preservation of postoperative renal function 5, 6. In early LPN series, suturing renorrhaphy of the renal cortex layer was considered an indispensable procedure to ensure hemostasis and closure of the urinary collecting system so that postoperative complications could be avoided. Robot-assisted partial nephrectomy (RAPN) and laparoscopic partial nephrectomy (LPN) are minimally invasive PN with recently expanded indications for complex and challenging renal tumors 3, 4. Partial nephrectomy (PN) is the gold standard definitive therapy for T1 renal masses with surgical indication 1, 2. CRO-RAPN contributed to shorter warm ischemic time, less blood loss, fewer complications, and higher preservation of renal function, all of which allowed this technique to achieve a higher rate of trifecta compared to CRO-LPN. 89%, P = 0.003), and higher trifecta achievement rate (84% vs.
16%, P = 0.001), higher preservation rate of eGFR at six months postoperatively (93% vs. 119 mL, P = 0.002), lower incidence of overall complications (3% vs. Compared to the CRO-LPN group, the CRO-RAPN group was associated with shorter warm ischemic time (13 min vs. Among 291 patients (CRO-RAPN, n = 210 CRO-LPN, n = 81) included in the study, 150 matched pairs of patients were analyzed.
The preservation rate of the estimated glomerular filtration rate (eGFR) was evaluated at six months postoperatively. Trifecta was defined as negative surgical margin, warm ischemic time < 25 min, and absence of complications of Clavien-Dindo grade III or more until three months postoperatively. The outcomes of the two groups were compared using propensity-score matching. Between July 2012 and June 2020, patients with localized clinical T1-2 renal masses who underwent CRO-RAPN or CRO-LPN were reviewed. laparoscopic (CRO-LPN) methods of cortical-renorrhaphy-omitting partial nephrectomy. To evaluate the surgical and functional outcomes between robot-assisted (CRO-RAPN) vs.
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