Abstracts EAU19 – 34th Annual EAU Congress
343 Perioperative morbidity of open, laparoscopic and robotic partial nephrectomy: A
prospective multicenter observational study (RECORD 2)
Eur Urol Suppl 2019; 18(1);e444
Bravi C.A. 1 , Larcher A. 1 , Capitanio U. 1 , Montorsi F. 1 , Antonelli A. 2 , Barale M. 3 , Bertini R. 1 , Bove P. 4 , Brunocilla E. 5 , Da Pozzo L. 6 , Di
Maida F. 7 , Gontero P. 3 , Li Marzi V. 8 , Longo N. 9 , Montanari E. 10 , Porpiglia F. 11 , Schiavina R. 12 , Simeone C. 2 , Siracusano S. 13 , Volpe
A. 14 , Ficarra V. 15 , Carini M. 11 , Mari A. 11 , Minervini A. 11
1
Urological Research Institute, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Unit of Urology, Division of
Experimental Oncology, Milan, Italy, 2Spedali Civili Hospital, University of Brescia, Dept. of Urology, Brescia, Italy, 3Department of Surgical
Sciences, San Giovanni Battista Hospital, University of Studies of Torino, Division of Urology, Turin, Italy, 4University Hospital of Tor Vergata,
Dept. of Urology, Rome, Italy, 5University of Bologna, Dept. of Urology; Department of Experimental, Diagnostic, and Specialty Medicine, Bologna,
Italy, 6Papa Giovanni XXIII Hospital, Dept. of Urology, Bergamo, Italy, 7University of Florence, Careggi Hospital, Dept. of Urology, Unit of
oncologic minimally-Invasive Urology and Andrology, Florence, Italy, 8University of Florence, Careggi Hospital, Dept. of Urology, Unit of urological
minimally invasive robotic surgery and renal transplantation, Florence, Italy, 9University Federico II of Naples, Dept. of Urology, Naples, Italy,
10
Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Policlinico, University of Milan, Dept. of Urology, Milan, Italy, 11San Luigi
Gonzaga Hospital, School of Medicine, Orbassano, Division of Urology, Dept. of Oncology, Turin, Italy, 12University of Bologna, Dept. of Urology;
Dept. of Experimental, Diagnostic, and Specialty Medicine, Bologna, Italy, 13Azienda Ospedaliera Universitaria Integrata (A.O.U.I.), Dept. of
Urology, Verona, Italy, 14Maggiore della Carità Hospital, Dept. of Urology, Novara, Italy, 15Gaetano Barresi, University of Messina, Dept. of Human
and Paediatric Pathology, Urologic Section, Messina, Italy
Introduction & Objectives: Surgical technique may affect the perioperative morbidity of partial nephrectomy. We aimed to compare the
perioperative outcomes of open, laparoscopic and robotic partial nephrectomy in a prospective observational study.
Materials & Methods: Data of 2,340 kidney cancer patients treated with NSS for cT1 renal tumors were extracted from the RECORd2 database,
a prospective observational multicenter national-based collaborative project. We built a multivariable model to assess the relationship between
surgical technique and surgical margins, ischemia time and postoperative complications. Moreover, we examined the probability to achieve a
modified trifecta (negative margins, warm ischemia time <25 minutes and no Clavien-Dindo ≥2 complications) for each surgical approach.
Results: In the overall population, laparoscopic and robotic techniques were associated with significantly lower rate of Clavien-Dindo ≥2
complications than that of open surgery (both p>0.059). The warm ischemia time was longer for the robotic technique when compared to
open surgery (OR: 3.92; 95%CI: 2.59, 5.26; p<0.0001) and laparoscopy (OR: 2.61, 95%CI: 1.48, 3.75; p=0.0001). Positive margins rate
did not differ between the groups (all p≥0.06). The probability to achieve a positive trifecta was not affected by surgical technique in the
overall population (all p≥0.059). In PADUA <10 lesions, patients treated robotically had higher probability to achieve a positive trifecta when
compared to those treated by open surgery (OR: 1.68; 95%CI: 1.10, 2.56; p=0.016) and laparoscopy (OR: 1.41; 95%CI: 0.99, 2.01; p=0.057).
Eur Urol Suppl 2019; 18(1);e444
Abstracts EAU19 – 34th Annual EAU Congress
Conclusions: Robotic partial nephrectomy had lower perioperative morbidity than open and laparoscopic surgery for PADUA <10 masses. In
anatomical complex lesions the difference between the approaches is not clinically meaningful.
Eur Urol Suppl 2019; 18(1);e445
