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- Title
Purely Off-Clamp Sutureless Robotic Partial Nephrectomy for Novice Robotic Surgeons: A Multi-Institutional Propensity Score-Matched Analysis.
- Authors
De Nunzio, Cosimo; Tema, Giorgia; Brassetti, Aldo; Anceschi, Umberto; Bove, Alfredo Maria; D'Annunzio, Simone; Ferriero, Mariaconsiglia; Mastroianni, Riccardo; Misuraca, Leonardo; Guaglianone, Salvatore; Tuderti, Gabriele; Leonardo, Costantino; Lombardo, Riccardo; Cicione, Antonio; Franco, Antonio; Bologna, Eugenio; Licari, Leslie Claire; Riolo, Sara; Flammia, Rocco Simone; Nacchia, Antonio
- Abstract
Objectives: To compare perioperative outcomes of patients treated with sutureless off-clamp robotic partial nephrectomy (sl-oc RAPN) by either a novice or an expert robotic surgeon at two different institutions. Methods: Data concerning two continuous series of patients with cT1-2N0M0 renal tumors treated with sl-oc RAPN either by a novice or an expert surgeon were extracted from prospectively populated institutional databases over the last 4 years. Perioperative outcomes as well as the baseline characteristics of patients and tumors were compared by using χ2 and Mann–Whitney tests for categorical and continuous variables, respectively. A 1:1 propensity match score analysis (PMSa) generated two homogeneous cohorts. Logistic regression analysis was performed to assess predictors of trifecta outcomes, defined as negative surgical margins, no Clavien–Dindo ≧ 3 grade complications, and no ≧ 30% postoperative eGFR reduction. Results: Overall, 328 patients were treated by an expert surgeon, while 40 were treated by a novice surgeon. After PMSa analysis, two cohorts of 23 patients each were generated, homogeneous for all baseline variables (p ≥ 0.07). Hospital stay was the only significantly different outcome observed between the two groups (5 days vs. 2 days; p < 0.001). No statistically significant differences were recorded when comparing trifecta outcomes (expert: 100% vs. novice: 87%; p = 0.07). In the logistic regression analysis, no statistically significant predictors of trifecta outcomes were recorded. Conclusions: sl-oc RAPN is a feasible and safe nephron sparing technique, even when performed by a novice robotic surgeon.
- Subjects
NEPHRECTOMY; SURGICAL margin; SURGEONS; LOGISTIC regression analysis; PROPENSITY score matching; ROBOTICS
- Publication
Journal of Clinical Medicine, 2024, Vol 13, Issue 12, p3553
- ISSN
2077-0383
- Publication type
Article
- DOI
10.3390/jcm13123553