Health-Related Quality of Life in Patients with Small Renal Mass Who Underwent Robot-Assisted Partial Nephrectomy: A Prospective Evaluation.

There have been insufficient data regarding the impact of partial nephrectomy (PN) with minimal invasive approaches, including robot-assisted PN (RAPN), on postoperative quality of life (QOL) in patients with small renal mass (SRM). The objective of this study was to investigate the changes in health-related QOL (HR-QOL) outcomes in patients with SRM who underwent RAPN. We performed a prospective observational study including 100 consecutive patients with SRM who underwent RAPN at our institution between April 2016 and August 2018. A single surgeon performed RAPN for all 100 cases using the da Vinci Xi. HR-QOL in these patients was assessed using the Medical Outcomes Study 8-Item Short-Form Health Survey (SF-8) before and 3, 6, and 12 months after RAPN. Mean age in the 100 patients was 63 years, and diabetes mellitus, hypertension, and chronic kidney disease were preoperatively detected in 22, 44, and 30 patients, respectively. Mean values of tumor diameter and R.E.N.A.L. nephrometry score were 25 mm and 7, respectively. Console and warm ischemia times during RAPN were 115 and 15 minutes, respectively. Of eight subscale scores of the SF-8 survey, three subscale scores before RAPN, bodily pain, role emotional, and mental health (MH), were significantly improved after RAPN. Furthermore, of two summary scores, mental health component summary (MCS), but not physical health component summary (PCS), showed a significant improvement postoperatively. Multivariate analyses of several factors revealed that despite the lack of factors associated with improved PCS, younger age (<65 years) had an independent impact on improved MCS. These findings suggest that patients undergoing RAPN could result in the achievement of favorable HR-QOL, particularly that reflecting MH status in younger patients.