Gautam Gagan, Ganpule Arvind, Kumar Anant, Keshavamurthy Mohan, Rawal Sudhir, Mavuduru Ravimohan, Ta Kishore, Pooleri Ginil Kumar, Dubey Deepak, Ragavan Narasimhan, Bakshi Hemang, Addla Sanjai, Raghunath S K, Gupta Divya, Malik Kamal, Dahiya Akhil
Department of Uro-Oncology and Robotic Surgery, Medanta - The Medicity, Gurugram, IND.
Urology, Muljibhai Patel Urological Hospital, Nadiad, IND.
Cureus. 2025 May 16;17(5):e84209. doi: 10.7759/cureus.84209. eCollection 2025 May.
Robotic-assisted partial nephrectomy (RPN) is increasingly recognized as an effective treatment for small renal masses. This study aims to highlight the therapeutic benefits of RPN for both small and relatively larger renal masses in the Indian population.
A retrospective chart review was conducted on patients who underwent RPN using the da Vinci surgical system between September 2010 and September 2022 across 14 centers located in various cities of India, including Ahmedabad, Bengaluru, Chandigarh, Chennai, Delhi, Gurugram, Hyderabad, Kochi, and Nadiad. Data on demographics, medical history, clinical characteristics, and perioperative, functional, and oncological outcomes were extracted from medical records and analyzed statistically.
A total of 1,267 patients were included in the study, with 757 in the T1a tumor group and 510 in the T1b+T2 tumor group. In terms of baseline characteristics, the two groups showed a significant difference (p < 0.001) in renal nephrometry score (RENAL score). The mean operating room time (201.31 ± 77.57 vs. 191.06 ± 74.51; p = 0.0021) and warm ischemia time (25.21 ± 8.08 vs. 22.51 ± 7.95; p < 0.001) were significantly higher in the T1b+T2 tumor groups. Other outcomes were comparable, namely, length of hospital stay (4.21 ± 2.47 vs. 4.05 ± 2.30 days; p = 0.2459), postoperative complications (3.33% vs. 2.11%; p = 0.181), conversion rates (0% vs. 0%), and surgical margins (3.04 vs. 4.31%, p = 0.229). There was no difference in recurrence rates, and no significant differences were observed in the functional outcomes between the two groups.
RPN provides encouraging surgical, oncological, and functional outcomes for both T1a and T1b+T2 renal masses, enabling nephron-sparing surgery and early recovery of renal function.
机器人辅助部分肾切除术（RPN）日益被认为是治疗小肾肿瘤的有效方法。本研究旨在强调RPN对印度人群中小肾肿瘤和相对较大肾肿瘤的治疗益处。
对2010年9月至2022年9月期间在印度各城市的14个中心（包括艾哈迈达巴德、班加罗尔、昌迪加尔、金奈、德里、古尔冈、海得拉巴、科钦和纳迪亚德）使用达芬奇手术系统接受RPN的患者进行回顾性病历审查。从病历中提取人口统计学、病史、临床特征以及围手术期、功能和肿瘤学结果的数据，并进行统计分析。
本研究共纳入1267例患者，其中T1a肿瘤组757例，T1b+T2肿瘤组510例。在基线特征方面，两组在肾计量评分（RENAL评分）上存在显著差异（p<0.001）。T1b+T2肿瘤组的平均手术室时间（201.31±77.57对191.06±74.51；p=0.0021）和热缺血时间（25.21±8.08对22.51±7.95；p<0.001）显著更长。其他结果具有可比性，即住院时间（4.21±2.47对4.05±2.30天；p=0.2459）、术后并发症（3.33%对2.11%；p=0.181）、转化率（0%对0%）和手术切缘（3.04对4.31%，p=0.229）。两组的复发率无差异，且在功能结果方面未观察到显著差异。
RPN为T1a和T1b+T2肾肿瘤提供了令人鼓舞的手术、肿瘤学和功能结果，能够实现保留肾单位手术并使肾功能早期恢复。
