Néphrectomie partielle robot-assistée versus néphrectomie partielle laparoscopique : expérience d'un centre français. [Robot-assisted partial nephrectomy versus laparoscopic partial nephrectomy: A single institution experience.]
Résumé
Objective To compare perioperative outcomes of robot-assisted partial nephrectomy (RAPN) and laparoscopic partial nephrectomy (LPN) in a single French institution. Patients Between February 2008 and April 2012, 98 patients underwent RAPN (n = 54) or NPL (n = 44) for a kidney tumor. Demographic data, perioperative and pathological outcomes were compared using Student's test and χ2 for continuous and categorical variables, respectively. Results Both groups were comparable for age, BMI, American Society of Anesthesiologists classification (ASA) and preoperative renal function (MDRD clearance). Tumor complexity was increased in the RAPN group (55.5 % vs. 29.5 % RENAL score ≥ 2, P = 0.05). There was no significant difference in terms of operative time (191 vs. 202 min, P = 0.2), tumor size (35 vs. 30 mm, P = 0.1) or positive margins (2 vs. 5, P = 0.14). However, there was a significant decrease in warm ischemia time (18 vs. 25.6 min, P = 0.004) and hospital stay (5.1 vs. 6.9 days, P = 0.003) for RAPN. Estimated blood loss was greater in the RAPN group (490 vs. 280 mL, P = 0.003), but the numbers of transfusions were similar (5 vs. 4 patients, P = 0.96). Urinary tract was more frequently entered in the RAPN group (28 vs. 12, P = 0.009). The complication rate was similar in both groups (28 % vs. 32 %, P = 0.66). Conclusion RAPN is feasible and reproducible. As in previous publications, our study confirms a potential benefit of RAPN concerning warm ischemia.