Functional and oncological outcomes of robot-assisted and laparoscopic partial nephrectomy

Ivanov A.G., Zingerenko M.B., Pervushin V.V., Timaev K.A., Ekhoyan M.M.

1) A.S. Loginov Moscow Clinical Scientific Center, Moscow Healthcare Department, Moscow, Russia; 2) City Clinical Hospital No. 31 named after Academician G.M. Savelyeva, Moscow Healthcare Department, Moscow, Russia

Background. Laparoscopic partial nephrectomy (LPN) and robot-assisted partial nephrectomy (RAPN) are widely used organ-sparing treatment methods for T1 renal cell carcinoma (RCC). Numerous international meta-analyses on this topic have shown that RAPN provides perioperative outcomes comparable to those of LPN, while offering additional advantages such as significantly lower blood loss and a shorter warm ischemia time. However, no superiority of either technique over the other has yet been demonstrated with regard to oncological outcomes and preservation of renal function.
Aim. To compare functional and oncological outcomes of laparoscopic and robot-assisted partial nephrectomy for RCC at A.S. Loginov Moscow Clinical Scientific Center with data from international studies.
Materials and methods. A search of current literature on outcomes of RAPN and LPN was performed using PubMed. The most relevant publications were analyzed and served as the basis for this study. In addition, we retrospectively analyzed the surgical outcomes of 277 patients who underwent surgery for RCC using the Da Vinci robotic surgical system (n=175, group 1) or a laparoscopic technique (n=102, group 2) at A.S. Loginov Moscow Clinical Scientific Center between 2019 and 2024. Functional and oncological outcomes were collected and compared between the two groups.
Results. The postoperative decline in creatinine clearance was significantly greater in patients in group 2. Positive surgical margins and recurrence of RCC were also significantly more common in group 2.
Conclusion. The use of a robotic system for partial nephrectomy is an alternative to the laparoscopic technique, providing reliable functional and oncological outcomes. This is supported both by studies from a number of international centers and by the results obtained at A.S. Loginov Moscow Clinical Scientific Center.

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About the Authors

Corresponding author: A.G. Ivanov – Urologic Oncologist, A.S. Loginov Moscow Clinical Scientific Center, Moscow Healthcare Department, Moscow, Russia; e-mail: alexboorn@gmail.com

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