Castaneda Peris, Masterson John, Naser-Tavakolian Aurash, Kim Irene, Najjar Reiad, Gupta Amit
Department of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Department of Urology, Weill Cornell Medical College, New York, NY, USA.
World J Urol. 2025 May 5;43(1):270. doi: 10.1007/s00345-025-05556-x.
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.
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.
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.
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.
对于常染色体显性多囊肾病（ADPKD）患者，传统上采用开放手术进行肾切除术。我们之前描述过我们进行机器人同步双侧肾切除术的经验。然而，关于开放肾切除术（ONx）与机器人肾切除术（RNx）对比的数据很少。在此，我们比较接受同步双侧肾切除术的ADPKD患者中ONx和RNx的手术结果。
我们对2015年1月至2023年11月在单一机构接受开放或机器人同步双侧肾切除术的ADPKD患者进行了回顾性研究。比较了患者特征、围手术期因素、肾脏大小和并发症发生率。
总体而言，17例患者接受了RNx，15例患者接受了ONx。在性别、术前体重指数或肾脏体积方面没有显著差异。接受ONx的患者估计失血量（EBL）、住院时间（LOS）显著更高，非自体输血和总体并发症发生率也更高。ONx组的并发症包括10例需要输血的患者和2例发生内脏损伤的患者。RNx组从肾切除到移植的时间明显更短。
ADPKD的机器人同步双侧肾切除术可能比传统开放手术具有优势，包括更低的EBL、更短的LOS、更低的总体并发症发生率、更轻的并发症，以及可能从肾切除到移植的时间更快。
