Initial experience of robot-assisted radical nephrectomy in Japan: Single institutional study of 12 cases.

Abstract

INTRODUCTION\nTo evaluate the initial experience of robot-assisted radical nephrectomy (RARN) in a single institution in Japan.\n\n\nMETHODS\nThis study included a total of 12 patients with renal tumors who were not preoperatively regarded as optimal candidates for robot-assisted partial nephrectomy (RAPN) and subsequently treated with RARN between April 2019 and June 2021 at our institution. Comprehensive perioperative outcomes in these patients were retrospectively analyzed.\n\n\nRESULTS\nOf the 12 included patients, 10 and two were male and female, respectively, and the median age was 66\u2009years. The median tumor diameter was 44\u2009mm, and four, four and four patients were classified into cT1a, cT1b and cT3a, respectively. There was no patient requiring open conversion, and the median operative and console times were 167 and 79\u2009minutes, respectively. The median estimated blood loss was 42\u2009cc, and no patient required blood transfusion. During the perioperative period, no major complication corresponding to Clavien-Dindo grade ≥3 occurred. Nine, two and one patient were pathologically diagnosed with clear cell carcinoma (CCC), non-CCC and benign cyst, respectively, and there was no patient who developed recurrent diseases.\n\n\nCONCLUSIONS\nConsidering complicated tumor characteristics not amenable to RAPN in this series, such as an intravenous tumor thrombus or previous history of open partial nephrectomy, perioperative outcomes of initial experience with RARN in Japan could be considered favorable. Collectively, these findings suggest that RARN may be a promising alternative to laparoscopic radical nephrectomy for patients with complicated renal tumors, contraindicated for RAPN.