Renorrafia sin sutura frente a renorrafia convencional con sutura en nefrectomía parcial robóti̇ca sin clampaje: análisis unicéntrico de emparejamiento por puntuación de propensión

Abstract

Introduction and objectives

Suture renorrhaphy persists as time-consuming in partial nephrectomy (PN) and carries the risk of renal arterial damage and renal functional loss. This study aims to compare the functional and oncological outcomes of the clampless and sutureless robotic PN (sRPN) with clampless conventional suture renorrhaphy RPN (cRPN).

Patients

A total of 173 consecutive patients who underwent RPN between January 2019 and December 2023 were reviewed from our center's database. Seventy six clampless (sutureless: 23; conventional suture renorrhaphy: 53) RPN were identified. A propensity score matched-pair analysis (PSM) was performed to homogenize the ingredients of the groups. Comprehensive evaluations of perioperative variables, functional and oncological results were performed before and after the PSM between the sRPN and cRPN.

Results

Before the PSM, median console time was 10 minutes shorter in the sRPN group but was not statistically significant. Estimated median blood loss was significantly lower in the sRPN group (P < .05). After PSM, 22 patients were matched in each group and all of the preoperative baseline characteristics were similar. Ratio of interpolar lines located tumors was higher in sRPN group (68.2% vs 31.2%) (P < .05). Median tumor diameter was 3 (1.5-7) cm in each group. The trifecta achievement ratios were 90.9% and 77.2% for sRPN and cRPN groups, respectively (P > .05). There were no differences in terms of median console times, estimated blood loss, drain removal times or eGFR changes.

Conclusions

In the treatment of small renal masses with clampless RPN, the sutureless technique can be applied with similar complication rates and functional, oncological outcomes as conventional sutured renorophy.