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A multi-institutional report of peri-operative and functional outcomes after robot-assisted partial nephrectomy in patients with a solitary kidney

  • Zeynep Gul
  • Kyle A. Blum
  • David J. Paulucci
  • Ronney Abaza
  • Daniel D. Eun
  • Akshay Bhandari
  • Ashok K. Hemal
  • James Porter
  • Ketan K. Badani
Original Article

Abstract

To evaluate peri- and post-operative outcomes after robotic partial nephrectomy (RPN) in patients with a solitary kidney. A multi-institutional database of 1868 patients was used to identify 35 patients with a solitary kidney who underwent RPN at six different centers from 2007 to 2016. Peri-operative outcomes were summarized with descriptive statistics. We assessed the change in eGFR over time with a linear mixed-effects model. Median operative time, ischemia time, and estimated blood loss were 172 min, 16 min, and 113 mL, respectively. There were no positive surgical margins. The median length of stay was 1 day (range 1–7), and over half (54.3%) of patients were discharged one post-operative day 1. Seven post-operative complications occurred in six patients (17.1%); of which four were Clavien I, two were Clavien II, and one was Clavien III. The linear decline in eGFR up to 24 month post-RPN was marginal and not significant (ß = − 0.14; 95% CI = − 0.51, 0.23; p = 0.453), with predicted mean eGFR decreasing from 59.2 to 55.8 mL/min/1.73 m2 at 24 months. These results suggest that, in patients with a solitary kidney, RPN is a safe and feasible treatment option. In patients with a solitary kidney, RPN did not significantly compromise renal function for up to 2 years after surgery.

Keywords

Renal cancer Nephron sparing surgery Solitary kidney Glomerular filtration rate Partial nephrectomy Robotics 

Notes

Funding

This study did not receive any funding.

Compliance with ethical standards

Conflict of interest

Ronney Abaza has received research funding from Conmed Inc. and educational program funding from Intuitive Surgical. James Porter has received research support from Ceerva, is on the advisory board for C-SATS, and is a speaker for Intuitive Surgical. Zeynep Gul, Kyle Blum, David Paulucci, Daniel Eun, Akshay Bhandari, Ashok Hemal, and Ketan Badani have no conflicts of interest to report.

Informed consent

Informed consent was obtained from all individual participants included in this study.

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Copyright information

© Springer-Verlag London Ltd., part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of UrologyIcahn School of Medicine at Mount SinaiNew York CityUSA
  2. 2.OhioHealth Dublin Methodist HospitalDublinUSA
  3. 3.Temple University School of MedicinePhiladelphiaUSA
  4. 4.Division of Urology, Mount Sinai Medical CenterColumbia University at Mount SinaiMiami BeachUSA
  5. 5.Wake Forest School of MedicineMedical Center Blvd., Wake Forest University Baptist Medical CenterWinston-SalemUSA
  6. 6.Swedish Urology GroupSwedish Medical CenterSeattleUSA

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