Mp67-04 Surgical Experience and Functional Outcomes After Laparoscopic and Robot-Assisted Partial Nephrectomy: Results From a Multi-Institutional Collaboration

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy V (MP67)1 May 2024MP67-04 SURGICAL EXPERIENCE AND FUNCTIONAL OUTCOMES AFTER LAPAROSCOPIC AND ROBOT-ASSISTED PARTIAL NEPHRECTOMY: RESULTS FROM A MULTI-INSTITUTIONAL COLLABORATION Carlo Andrea Bravi, Stefano Tappero, Paolo Dell'Oglio, Riccardo Campi, Riccardo Bertolo, Marco Roscigno, Angela Pecoraro, Giuseppe Simone, Nazareno Suardi, Riccardo Schiavina, Karim Bensalah, Erdem Canda, Xu Zhang, Carlo Terrone, Shahrokh Shariat, Francesco Porpiglia, Alessandro Antonelli, Jihad Kaouk, Ketan Badani, Andrea Minervini, Ithaar Derweesh, Alberto Breda, Alexandre Mottrie, Francesco Montorsi, and Francesco Montorsi Carlo Andrea BraviCarlo Andrea Bravi , Stefano TapperoStefano Tappero , Paolo Dell'OglioPaolo Dell'Oglio , Riccardo CampiRiccardo Campi , Riccardo BertoloRiccardo Bertolo , Marco RoscignoMarco Roscigno , Angela PecoraroAngela Pecoraro , Giuseppe SimoneGiuseppe Simone , Nazareno SuardiNazareno Suardi , Riccardo SchiavinaRiccardo Schiavina , Karim BensalahKarim Bensalah , Erdem CandaErdem Canda , Xu ZhangXu Zhang , Carlo TerroneCarlo Terrone , Shahrokh ShariatShahrokh Shariat , Francesco PorpigliaFrancesco Porpiglia , Alessandro AntonelliAlessandro Antonelli , Jihad KaoukJihad Kaouk , Ketan BadaniKetan Badani , Andrea MinerviniAndrea Minervini , Ithaar DerweeshIthaar Derweesh , Alberto BredaAlberto Breda , Alexandre MottrieAlexandre Mottrie , Francesco MontorsiFrancesco Montorsi , and Francesco MontorsiFrancesco Montorsi View All Author Informationhttps://doi.org/10.1097/01.JU.0001009496.54470.10.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: In patients treated with partial nephrectomy, prior evidence showed that peri-operative outcomes such as complications and ischemia time improved as a function of surgical experience of the surgeon, but data on functional outcomes after surgery are still scarce. METHODS: We retrospectively analyzed data of 4,011 patients with a single, unilateral cT1a-b renal mass treated with laparoscopic or robot-assisted partial nephrectomy by 119 surgeons at 22 participating institutions between 1997 and 2022. Multivariable models tested the association between surgical experience (number of prior operations) and acute kidney injury (AKI) and recovery of at least 90% of baseline estimated glomerular filtration rate (eGFR) 1 yr after partial nephrectomy. RESULTS: A total of 753 (19%) and 3258 (81%) patients underwent laparoscopic and robot-assisted partial nephrectomy, respectively. Overall, 37 (31%) and 55 (46%) surgeons contributed only to laparoscopic and robotic learning curves, whereas 27 (23%) contributed to both approaches. In the laparoscopic group, 8% and 55% of patients developed AKI and recovered at least 90% of their baseline eGFR. After adjusting for confounders, we did not find evidence of an association between surgical experience and AKI after laparoscopic partial nephrectomy (p=0.6). Similar results were found when 1-year renal function was analysed (p=0.5). Among patients undergone robot-assisted partial nephrectomy, AKI occurred in 11% of patients, whereas 54% recovered at least 90% of their baseline eGFR. On multivariable analyses, the relationship between surgical experience and AKI after surgery was not statistically significant (p=0.2), with similar results when assessing renal function one year after surgery (p=0.9; Figure 1). CONCLUSIONS: In patients treated with laparoscopic or robot-assisted partial nephrectomy, our data suggest that surgical experience of the operating surgeon might not be a key determinant of functional recovery after surgery. This raises questions about the use of serum markers to assess functional recovery in patients with two kidneys, and opens the discussion on what are the key steps of the procedure that allowed surgeons to achieve optimal outcomes since their initial cases analysed separately. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1097 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Carlo Andrea Bravi More articles by this author Stefano Tappero More articles by this author Paolo Dell'Oglio More articles by this author Riccardo Campi More articles by this author Riccardo Bertolo More articles by this author Marco Roscigno More articles by this author Angela Pecoraro More articles by this author Giuseppe Simone More articles by this author Nazareno Suardi More articles by this author Riccardo Schiavina More articles by this author Karim Bensalah More articles by this author Erdem Canda More articles by this author Xu Zhang More articles by this author Carlo Terrone More articles by this author Shahrokh Shariat More articles by this author Francesco Porpiglia More articles by this author Alessandro Antonelli More articles by this author Jihad Kaouk More articles by this author Ketan Badani More articles by this author Andrea Minervini More articles by this author Ithaar Derweesh More articles by this author Alberto Breda More articles by this author Alexandre Mottrie More articles by this author Francesco Montorsi More articles by this author Francesco Montorsi More articles by this author Expand All Advertisement PDF downloadLoading ...