Surgical outcomes of robotic bilateral nephrectomy compared to open surgery in adult polycystic kidney disease.

PURPOSE

Native nephrectomies for patients with autosomal dominant polycystic kidney disease (ADPKD) have traditionally been performed via an open approach. We have previously described our experience with robotic synchronous bilateral nephrectomies. However, little data is available comparing open nephrectomy (ONx) to robotic nephrectomy (RNx). Here we compare outcomes of ONx and RNx in patients with ADPKD undergoing synchronous bilateral nephrectomy.

METHODS

We performed a retrospective review of patients with ADPKD undergoing open or robotic synchronous bilateral nephrectomy from January 2015 to November 2023 at a single institution. Patient characteristics, perioperative factors, kidney size, and complication rates were compared.

RESULTS

Overall, seventeen patients underwent RNx and fifteen patients underwent ONx. There was no significant difference in gender, preoperative BMI, or kidney volume. Patients undergoing ONx had significantly higher estimated blood loss (EBL), length of stay (LOS), and higher rates of non-autologous blood transfusion and complications overall. Complications in the ONx group included 10 patients who required blood transfusions and 2 patients who sustained visceral injuries. Time from nephrectomy to transplant was significantly shorter in the RNx arm.

CONCLUSION

Robotic synchronous bilateral nephrectomies for ADPKD may have advantages over the traditional open approach, including lower EBL, shorter LOS, decreased overall complication rates, less severe complications and potentially faster time from nephrectomy to transplant.