Login to Access Video or Poster Abstract: MP49-09
Sources of Funding: None

Introduction

Enucleation may be realistic method for preserving the normal renal parenchyma in partial nephrectomy (PN) if oncological or surgical outcomes are feasible. The surface-intermediate-base (SIB) score is proposed for the standardized reporting of resection techniques in PN. We compared surgical outcomes, defined according to SIB score, of robot-assisted laparoscopic partial nephrectomy (RAPN) between the resection and the enucleation._x000D_

Methods

Patients who underwent RAPN between 2013 and 2016 participated in our study. SIB score was macroscopically evaluated immediately after the surgery. We divided patients into the following two groups: enucleation (SIB score of 1 or 2) and resection (SIB score of 3-5). The following outcomes were compared between the two groups: decrease in estimated glomerular filtration rate (eGFR), ischemia time, console time, estimated blood loss, surgical margin status, incidence of urological complications. Multivariate linear regression analysis was performed to demonstrate the predictive factors of decrease in eGFR. Postoperative eGFR was evaluated between 1 and 3 months after surgery._x000D_

Results

This study included 283 patients, 48 patients in the enucleation and 235 patients in the resection. The patients&[prime] background (age, sex, and body mass index, preoperative eGFR) were not significantly different between the two groups. The patients in the enucleation had more complex (RENAL NS, 10-12; enucleation, 29% vs. resection, 8%) and larger tumors (enucleation, 34 mm vs. resection, 28 mm) than patients in the resection. The incidence rates of urological complication and negative surgical margin were not significantly different. Multivariate linear regression analysis revealed that higher age, higher-complexity tumor, longer warm ischemia time, better preoperative eGFR, and resection technique (vs. enucleation) were predictive factors of a higher decrease in eGFR (Table)._x000D_

Conclusions

The enucleation was applied to high- complexity tumors. The multivariate analysis revealed that the enucleation might be better than the resection technique in terms of preservation of renal function with similar oncological outcomes._x000D_

Funding

None