Cargando…
Perioperative outcomes following robot-assisted partial nephrectomy for complex renal masses: A Vattikuti Collective Quality Initiative database study
INTRODUCTION: Outcomes of robot-assisted partial nephrectomy (RAPN) depend on tumor complexity, surgeon experience and patient profile among other variables. We aimed to study the perioperative outcomes of RAPN for patients with complex renal masses using the Vattikuti Collective Quality Initiative...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer - Medknow
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9787447/ https://www.ncbi.nlm.nih.gov/pubmed/36568454 http://dx.doi.org/10.4103/iju.iju_154_22 |
_version_ | 1784858513881694208 |
---|---|
author | Sharma, Gopal Shah, Milap Ahluwalia, Puneet Dasgupta, Prokar Challacombe, Benjamin J. Bhandari, Mahendra Ahlawat, Rajesh Rawal, Sudhir Buffi, Nicolo M. Sivaraman, Ananthakrishnan Porter, James R. Rogers, Craig Mottrie, Alexandre Abaza, Ronney Rha, Khoon Ho Moon, Daniel Thyavihally, Yuvaraja B. Parekh, Dipen J. Capitanio, Umberto Maes, Kris K. Porpiglia, Francesco Turkeri, Levent Gautam, Gagan |
author_facet | Sharma, Gopal Shah, Milap Ahluwalia, Puneet Dasgupta, Prokar Challacombe, Benjamin J. Bhandari, Mahendra Ahlawat, Rajesh Rawal, Sudhir Buffi, Nicolo M. Sivaraman, Ananthakrishnan Porter, James R. Rogers, Craig Mottrie, Alexandre Abaza, Ronney Rha, Khoon Ho Moon, Daniel Thyavihally, Yuvaraja B. Parekh, Dipen J. Capitanio, Umberto Maes, Kris K. Porpiglia, Francesco Turkeri, Levent Gautam, Gagan |
author_sort | Sharma, Gopal |
collection | PubMed |
description | INTRODUCTION: Outcomes of robot-assisted partial nephrectomy (RAPN) depend on tumor complexity, surgeon experience and patient profile among other variables. We aimed to study the perioperative outcomes of RAPN for patients with complex renal masses using the Vattikuti Collective Quality Initiative (VCQI) database that allowed evaluation of multinational data. METHODS: From the VCQI, we extracted data for all the patients who underwent RAPN with preoperative aspects and dimensions used for an anatomical (PADUA) score of ≥10. Multivariate logistic regression was conducted to ascertain predictors of trifecta (absence of complications, negative surgical margins, and warm ischemia times [WIT] <25 min or zero ischemia) outcomes. RESULTS: Of 3,801 patients, 514 with PADUA scores ≥10 were included. The median operative time, WIT, and blood loss were 173 (range 45–546) min, 21 (range 0–55) min, and 150 (range 50–3500) ml, respectively. Intraoperative complications and blood transfusions were reported in 2.1% and 6%, respectively. In 8.8% of the patients, postoperative complications were noted, and surgical margins were positive in 10.3% of the patients. Trifecta could be achieved in 60.7% of patients. Clinical tumor size, duration of surgery, WIT, and complication rates were significantly higher in the group with a high (12 or 13) PADUA score while the trifecta was significantly lower in this group (48.4%). On multivariate analysis, surgical approach (retroperitoneal vs. transperitoneal) and high PADUA score (12/13) were identified as predictors of the trifecta outcomes. CONCLUSION: RAPN may be a reasonable surgical option for patients with complex renal masses with acceptable perioperative outcomes. |
format | Online Article Text |
id | pubmed-9787447 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Wolters Kluwer - Medknow |
record_format | MEDLINE/PubMed |
spelling | pubmed-97874472022-12-24 Perioperative outcomes following robot-assisted partial nephrectomy for complex renal masses: A Vattikuti Collective Quality Initiative database study Sharma, Gopal Shah, Milap Ahluwalia, Puneet Dasgupta, Prokar Challacombe, Benjamin J. Bhandari, Mahendra Ahlawat, Rajesh Rawal, Sudhir Buffi, Nicolo M. Sivaraman, Ananthakrishnan Porter, James R. Rogers, Craig Mottrie, Alexandre Abaza, Ronney Rha, Khoon Ho Moon, Daniel Thyavihally, Yuvaraja B. Parekh, Dipen J. Capitanio, Umberto Maes, Kris K. Porpiglia, Francesco Turkeri, Levent Gautam, Gagan Indian J Urol Original Article INTRODUCTION: Outcomes of robot-assisted partial nephrectomy (RAPN) depend on tumor complexity, surgeon experience and patient profile among other variables. We aimed to study the perioperative outcomes of RAPN for patients with complex renal masses using the Vattikuti Collective Quality Initiative (VCQI) database that allowed evaluation of multinational data. METHODS: From the VCQI, we extracted data for all the patients who underwent RAPN with preoperative aspects and dimensions used for an anatomical (PADUA) score of ≥10. Multivariate logistic regression was conducted to ascertain predictors of trifecta (absence of complications, negative surgical margins, and warm ischemia times [WIT] <25 min or zero ischemia) outcomes. RESULTS: Of 3,801 patients, 514 with PADUA scores ≥10 were included. The median operative time, WIT, and blood loss were 173 (range 45–546) min, 21 (range 0–55) min, and 150 (range 50–3500) ml, respectively. Intraoperative complications and blood transfusions were reported in 2.1% and 6%, respectively. In 8.8% of the patients, postoperative complications were noted, and surgical margins were positive in 10.3% of the patients. Trifecta could be achieved in 60.7% of patients. Clinical tumor size, duration of surgery, WIT, and complication rates were significantly higher in the group with a high (12 or 13) PADUA score while the trifecta was significantly lower in this group (48.4%). On multivariate analysis, surgical approach (retroperitoneal vs. transperitoneal) and high PADUA score (12/13) were identified as predictors of the trifecta outcomes. CONCLUSION: RAPN may be a reasonable surgical option for patients with complex renal masses with acceptable perioperative outcomes. Wolters Kluwer - Medknow 2022 2022-10-01 /pmc/articles/PMC9787447/ /pubmed/36568454 http://dx.doi.org/10.4103/iju.iju_154_22 Text en Copyright: © 2022 Indian Journal of Urology https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Sharma, Gopal Shah, Milap Ahluwalia, Puneet Dasgupta, Prokar Challacombe, Benjamin J. Bhandari, Mahendra Ahlawat, Rajesh Rawal, Sudhir Buffi, Nicolo M. Sivaraman, Ananthakrishnan Porter, James R. Rogers, Craig Mottrie, Alexandre Abaza, Ronney Rha, Khoon Ho Moon, Daniel Thyavihally, Yuvaraja B. Parekh, Dipen J. Capitanio, Umberto Maes, Kris K. Porpiglia, Francesco Turkeri, Levent Gautam, Gagan Perioperative outcomes following robot-assisted partial nephrectomy for complex renal masses: A Vattikuti Collective Quality Initiative database study |
title | Perioperative outcomes following robot-assisted partial nephrectomy for complex renal masses: A Vattikuti Collective Quality Initiative database study |
title_full | Perioperative outcomes following robot-assisted partial nephrectomy for complex renal masses: A Vattikuti Collective Quality Initiative database study |
title_fullStr | Perioperative outcomes following robot-assisted partial nephrectomy for complex renal masses: A Vattikuti Collective Quality Initiative database study |
title_full_unstemmed | Perioperative outcomes following robot-assisted partial nephrectomy for complex renal masses: A Vattikuti Collective Quality Initiative database study |
title_short | Perioperative outcomes following robot-assisted partial nephrectomy for complex renal masses: A Vattikuti Collective Quality Initiative database study |
title_sort | perioperative outcomes following robot-assisted partial nephrectomy for complex renal masses: a vattikuti collective quality initiative database study |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9787447/ https://www.ncbi.nlm.nih.gov/pubmed/36568454 http://dx.doi.org/10.4103/iju.iju_154_22 |
work_keys_str_mv | AT sharmagopal perioperativeoutcomesfollowingrobotassistedpartialnephrectomyforcomplexrenalmassesavattikuticollectivequalityinitiativedatabasestudy AT shahmilap perioperativeoutcomesfollowingrobotassistedpartialnephrectomyforcomplexrenalmassesavattikuticollectivequalityinitiativedatabasestudy AT ahluwaliapuneet perioperativeoutcomesfollowingrobotassistedpartialnephrectomyforcomplexrenalmassesavattikuticollectivequalityinitiativedatabasestudy AT dasguptaprokar perioperativeoutcomesfollowingrobotassistedpartialnephrectomyforcomplexrenalmassesavattikuticollectivequalityinitiativedatabasestudy AT challacombebenjaminj perioperativeoutcomesfollowingrobotassistedpartialnephrectomyforcomplexrenalmassesavattikuticollectivequalityinitiativedatabasestudy AT bhandarimahendra perioperativeoutcomesfollowingrobotassistedpartialnephrectomyforcomplexrenalmassesavattikuticollectivequalityinitiativedatabasestudy AT ahlawatrajesh perioperativeoutcomesfollowingrobotassistedpartialnephrectomyforcomplexrenalmassesavattikuticollectivequalityinitiativedatabasestudy AT rawalsudhir perioperativeoutcomesfollowingrobotassistedpartialnephrectomyforcomplexrenalmassesavattikuticollectivequalityinitiativedatabasestudy AT buffinicolom perioperativeoutcomesfollowingrobotassistedpartialnephrectomyforcomplexrenalmassesavattikuticollectivequalityinitiativedatabasestudy AT sivaramanananthakrishnan perioperativeoutcomesfollowingrobotassistedpartialnephrectomyforcomplexrenalmassesavattikuticollectivequalityinitiativedatabasestudy AT porterjamesr perioperativeoutcomesfollowingrobotassistedpartialnephrectomyforcomplexrenalmassesavattikuticollectivequalityinitiativedatabasestudy AT rogerscraig perioperativeoutcomesfollowingrobotassistedpartialnephrectomyforcomplexrenalmassesavattikuticollectivequalityinitiativedatabasestudy AT mottriealexandre perioperativeoutcomesfollowingrobotassistedpartialnephrectomyforcomplexrenalmassesavattikuticollectivequalityinitiativedatabasestudy AT abazaronney perioperativeoutcomesfollowingrobotassistedpartialnephrectomyforcomplexrenalmassesavattikuticollectivequalityinitiativedatabasestudy AT rhakhoonho perioperativeoutcomesfollowingrobotassistedpartialnephrectomyforcomplexrenalmassesavattikuticollectivequalityinitiativedatabasestudy AT moondaniel perioperativeoutcomesfollowingrobotassistedpartialnephrectomyforcomplexrenalmassesavattikuticollectivequalityinitiativedatabasestudy AT thyavihallyyuvarajab perioperativeoutcomesfollowingrobotassistedpartialnephrectomyforcomplexrenalmassesavattikuticollectivequalityinitiativedatabasestudy AT parekhdipenj perioperativeoutcomesfollowingrobotassistedpartialnephrectomyforcomplexrenalmassesavattikuticollectivequalityinitiativedatabasestudy AT capitanioumberto perioperativeoutcomesfollowingrobotassistedpartialnephrectomyforcomplexrenalmassesavattikuticollectivequalityinitiativedatabasestudy AT maeskrisk perioperativeoutcomesfollowingrobotassistedpartialnephrectomyforcomplexrenalmassesavattikuticollectivequalityinitiativedatabasestudy AT porpigliafrancesco perioperativeoutcomesfollowingrobotassistedpartialnephrectomyforcomplexrenalmassesavattikuticollectivequalityinitiativedatabasestudy AT turkerilevent perioperativeoutcomesfollowingrobotassistedpartialnephrectomyforcomplexrenalmassesavattikuticollectivequalityinitiativedatabasestudy AT gautamgagan perioperativeoutcomesfollowingrobotassistedpartialnephrectomyforcomplexrenalmassesavattikuticollectivequalityinitiativedatabasestudy |