Journals / Haydarpaşa Numune Medical Journal / 2020 / Cilt: 60 - Sayı: 3
Does the Surgical Technique Affect the Results of Partial Nephrectomy Performed for Renal Cell Carcinoma? Single-center 'MIC' Score and 'Trifecta' Results
- Pages
- 234–240
- DOI
- —
Abstract
Introduction: To report the MIC scores and trifecta rates in patients who underwent partial nephrectomy with open (OPN),laparoscopic (LPN) and robot-assisted techniques (RPN) due to kidney tumor.Methods: Demographic characteristics, tumor characteristics, peri-and post-operative data and complications of the patients who underwent OPN (n=58), LPN (n=32) and RPN (n=126) between 2007 and August 2018 due to kidney tumor andhistopathological features were evaluated retrospectively in this study. To report oncological and functional outcomes ofnephron-sparing surgery for renal tumors, MIC (surgical margin negativity, ischemia duration less than 20 minutes and lackof complication) and Trifecta (surgical margin negativity, perioperative complications and glomerular filtration rate (GFR)>90% protection rate) were used.Results: RPN was superior to OPN technique in hospitalization and estimated bleeding. Transfusion rate and all complications were similar in all three techniques. Although OPN had shorter operation time and ischemia time, there was a higheramount of blood loss and hospital stay. No significant difference was found between all three techniques for surgical marginpositivity and >90% preservation of GFR. The mean duration of warm ischemia was 23.6 minutes with the longest LPN, followed by a mean of 18.4 minutes with an RPN and a mean of 16.6 minutes with OPN (p=0.003). It was significantly longer.Our MIC score was 79% in OPN, 71% in LPN and 81.7% in RPN (p=0.04). Our Trifectaoranes were 87% in OPN, 87.5% in LPNand 93.6% in RPN (p=0.128).Discussion and Conclusion: Both the 'MIC score system 'and the 'Trifecta' system are easy to use and reproducible systemsfor reporting partial nephrectomy results for renal tumors. Robot-assisted partial nephrectomy is the most powerful alternative technique for open partial nephrectomy with low complication rates, shorter operation time, similar ischemia durationsand oncologic outcomes.