Perioperative outcomes following robot-assisted partial nephrectomy in elderly patients

Gopal Sharma, Milap Shah, Puneet Ahluwalia, Prokar Dasgupta, Benjamin J. Challacombe, Mahendra Bhandari, Rajesh Ahlawat, Sudhir Rawal, Nicolo M. Buffi, Ananthakrishanan Sivaraman, James R. Porter, Craig Rogers, Alexandre Mottrie, Ronney Abaza, Khoon Ho Rha, Daniel Moon, Thyavihally B. Yuvaraja, Dipen J. Parekh, Umberto Capitanio, Kris K. MaesFrancesco Porpiglia, Levent Turkeri, Gagan Gautam

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)

Abstract

Objective: To compare perioperative outcomes following robot-assisted partial nephrectomy (RAPN) in patients with age ≥ 70 years to age < 70 years. Methods: Using Vattikuti Collective quality initiative (VCQI) database for RAPN we compared perioperative outcomes following RAPN between the two age groups. Primary outcome of the study was to compare trifecta outcomes between the two groups. Propensity matching using nearest neighbourhood method was performed with trifecta as primary outcome for sex, body mass index (BMI), solitary kidney, tumor size and Renal nephrometery score (RNS). Results: Group A (age ≥ 70 years) included 461 patients whereas group B included 1932 patients. Before matching the two groups were statistically different for RNS and solitary kidney rates. After propensity matching, the two groups were comparable for baselines characteristics such as BMI, tumor size, clinical symptoms, tumor side, face of tumor, solitary kidney and tumor complexity. Among the perioperative outcome parameters there was no difference between two groups for operative time, blood loss, intraoperative transfusion, intraoperative complications, need for radical nephrectomy, positive margins and trifecta rates. Warm ischemia time was significantly longer in the younger age group (18.1 min vs. 16.3 min, p = 0.003). Perioperative complications were significantly higher in the older age group (11.8% vs. 7.7%, p = 0.041). However, there was no difference between the two groups for major complications. Conclusion: RAPN in well-selected elderly patients is associated with comparable trifecta outcomes with acceptable perioperative morbidity.

Original languageEnglish
Pages (from-to)2789-2798
Number of pages10
JournalWorld Journal of Urology
Volume40
Issue number11
DOIs
Publication statusPublished - 2022 Nov

Bibliographical note

Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

All Science Journal Classification (ASJC) codes

  • Urology

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