MINIMALLY INVASIVE LAPAROSCOPIC AND ROBOT ASSISTED PARTIAL NEPHRECTOMY: A BRIEF HISTORY AND REVIEW

Česká verzia

Authors: E. S. Wisenbaugh; S. M. Cheney; G. L. Martin; B. Rocco; E. P. Castle
Authors place of work: Mayo Clinic Arizona
Published in the journal: Urol List 2011; 9(4): 17-21

Summary

Robot assisted partial nephrectomy (RAPN) has recently emerged as an alternative approach to pure laparoscopy for minimally invasive nephron sparing surgery for small renal tumors, and it’s benefits are still being evaluated. We summarize the evolution of treatment of these small tumors, and review the literature of direct comparisons between the laparoscopic and the robot assisted approach. Results from the largest studies to date suggest there may be a benefit in reducing warm ischemia time with the robot. Benefits in the other parameters measured such as operative time, estimated blood loss, complication rates and positive surgical margins were less clear, but seem to be at least comparable between the two approaches. We conclude that while the benefits to using the robotic approach need to be further investigated, outcomes so far appear to be at least equivalent to pure laparoscopy. Other important benefits include facilitation of dissection in more complex renal masses, and creating wider access to nephron-sparing surgery in the community.

Key words:
robot assisted partial nephrectomy, laparoscopic partial nephrectomy, T1 renal tumors, nephron sparing surgery

Zdroje

1. Pantuck AJ, Amnon Z, Belldegrun AS. The Changing History of Renal Cell Carcinoma. J Urol 2001; 166(5): 1611–1623.

2. Jemal A, Siegel R, Ward E et al. Cancer Statistics, 2009. CA Cancer J Clin 2009; 59(4): 225–249.

3. Lang K, Danchenko N, Gondek K et al. The burden of illness associated with renal cell carcinoma in the United States. Urol Oncol 2007; 25(5): 368–375.

4. Robson CJ. Radical nephrectomy for renal cell carcinoma. J Urol 1963; 89: 37–42.

5. Lau WK, Blute ML, Weaver AL et al. Matched comparison of radical nephrectomy vs. nephron-sparing surgery in patients with unilateral renal cell carcinoma and a contralateral kidney. Mayo Clin Proc 2000; 75(12): 1236–1242.

6. McKiernan J, Simmons R, Katz J et al. Natural history of chronic renal insufficiency after partial and radical nephrectomy. Urology 2002; 59(6): 816–820.

7. Herr HW. Partial nephrectomy for unilateral renal carcinoma and a normal contralateral kidney: 10-year followup. J Urol 1999; 161(1): 33–34.

8. Antonelli A, Cozzoli A, Nicolai M et al. Nephron-sparing surgery versus radical nephrectomy in the treatment of intracapsular renal cell carcinoma up to 7 cm. Eur Urol 2008; 53(4): 803–809.

9. Mitchell RE, Gilbert SM, Murphy AM et al. Partial nephrectomy and radical nephrectomy offer similar cancer outcomes in renal cortical tumors 4 cm or larger. Urology 2006; 67(2): 260–264.

10. Thompson RH, Siddiqui S, Lohse SM et al. Partial versus radical nephrectomy for 4 to 7 cm renal cortical tumors. J Urol 2009; 182(6): 2601–2606.

11. Huang WC, Elkin EB, Levey AS et al. Partial nephrectomy versus radical nephrectomy in patients with small renal tumors – is there a difference in mortality and cardiovascular outcomes? J Urol 2009; 181(1): 55–61.

12. Thompson RH, Boorjian SA, Lohse CM et al. Radical nephrectomy for pT1a renal masses may be associated with decreased overall survival compared with partial nephrectomy. J Urol 2008; 179(2): 468–471.

13. Campbell SC, Novick AC, Belldegrun A et al. Guideline for management of the clinical T1 renal mass. J Urol 2009; 182: 1271–1279.

14. Abouassaly R, Alibhai SM, Tomlinson G et al. Unintended consequences of laparoscopic surgery on partial nephrectomy for kidney cancer. J Urol 2010; 183(2): 467–472.

15. Lane BR, Gill IS. 7-year oncological outcomes after laparoscopic and open partial nephrectomy. J Urol 2010; 183(2): 473–479.

16. Gill IS, Kavoussi LR, Lane BR et al. Comparison of 1,800 laparoscopic and open partial nephrectomies for single renal tumors. J Urol 2007; 178(1): 41–46.

17. Ficarra V, Novara G, Mottrie A et al. AUA Update series 2010.

18. Gettman MT, Blute ML, Chow GK et al. Robotic-assisted laparoscopic partial nephrectomy: technique and initial experience with DaVinci robotic system. Urology 2004; 64(5): 914–918.

19. Aron M, Koenig P, Kaouk JK et al. Robotic and laparoscopic partial nephrectomy: a matched-pair comparison from a high-volume centre. BJU Int 2008; 102(1): 86–92.

20. Benway BM, Bhayani SB, Rogers CG et al. Robot assisted partial nephrectomy versus laparoscopic partial nephrectomy for renal tumors: a multi-institutional analysis of perioperative outcomes. J Urol 2009; 182(3): 866–872.

21. Deane LA, Lee HJ, Box GN et al. Robotic versus standard laparoscopic partial/wedge nephrectomy: a comparison of intraoperative and perioperative results from a single institution. J Endourol 2008; 22(5): 947–952.

22. DeLong JM, Shapiro O, Moinzadeh A. Comparison of laparoscopic versus robotic assisted partial nephrectomy: one surgeon’s initial experience. Can J Urol 2010; 17(3): 5207–5212.

23. Haber GP, White WM, Crouzet SC et al. Robotic versus laparoscopic partial nephrectomy: single-surgeon matched cohort study of 150 patients. Urology 2010; 76(3): 754–758.

24. Kural AR, Atug F, Tufek I et al. Robot-assisted partial nephrectomy versus laparoscopic partial nephrectomy: comparison of outcomes. J Endourol 2009; 23(9): 1491–1497.

25. Jeong W, Park SY, Lorenzo EI et al. Laparoscopic partial nephrectomy versus robot-assisted laparoscopic partial nephrectomy. J Endourol 2009; 23(9): 1457–1460.

26. Wang AJ, Bhayani SB. Robotic partial nephrectomy versus laparoscopic partial nephrectomy for renal cell carcinoma: single-surgeon analysis of > 100 consecutive procedures. Urology 2009; 73(2): 306–310.

27. Williams SB, Kacker R, Alemozaffar M et al. Robotic partial nephrectomy versus laparoscopic partial nephrectomy: a single laparoscopic trained surgeon’s experience in the development of a robotic partial nephrectomy program. World J Urol 2011 [Epub ahead of print].

28. Rogers C, Sukumar S, Gill IS. Robotic partial nephrectomy: the real benefit. Curr Opin Urol 2011; 21(1): 60–64.

29. Desai PJ, Andrews PE, Ferrigni RG et al. Laparoscopic partial nephrectomy at the Mayo Clinic Arizona: follow-up surveillance of positive margin disease. Urology 2008; 71(2): 283–286.

30. Mir SA, Cadeddu JA, Sleeper JP et al. Cost comparison of robotic, laparoscopic, and open partial nephrectomy. J Endourol 2011; 25(3): 447–453.