Comparison of differences in intraoperative blood loss between left-sided and right-sided robot-assisted partial nephrectomy.

Abstract

This study investigates robot-assisted partial nephrectomy for small-diameter renal tumors, specifically focusing on intraoperative blood loss differences between left and right sides. The study, referenced as ROID2114, involved a retrospective analysis of 173 patients who underwent robot-assisted partial nephrectomy for renal tumors at our institution from November 2016 to March 2024. We evaluated the demographic data, operative duration, and blood loss between groups with right-sided and left-sided tumors. Increased blood loss was classified as a 75th percentile threshold of ≥ 200 ml, and multivariate analysis was conducted to identify risk factors associated with elevated blood loss. Among the patients, 93 (53.8%) had right-sided tumors. No significant differences were found in age, operative time, RENAL score, tumor size, body mass index (BMI), MAP score, or surgical approach between the two sides; however, intraoperative blood loss was notably higher on the right side (100 mL) compared to the left (50 mL, p = 0.016). The multivariate analysis identified several factors linked to increased blood loss: extended operative time (≥ 202 min; p = 0.01, odds ratio 2.81, 95% CI 1.26-6.28), larger tumor size (≥ 27 mm; p = 0.04, odds ratio 2.21, 95% CI 1.02-4.81), and right-sided tumors (p = 0.01, odds ratio 2.82, 95% CI 1.28-6.23). Thus, right-sided tumors, longer operative durations, and RENAL scores exceeding 6 are correlated with heightened intraoperative blood loss in robot-assisted partial nephrectomy.