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Sawada et al. Mini-invasive Surg 2021;5:6 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2020.100

Original Article Open Access

Comparative analysis of perioperative outcomes
between robot-assisted partial nephrectomy and

open partial nephrectomy: a propensity-matched
study

Atsuro Sawada, Takashi Kobayashi, Takehiro Takahashi, Jin Kono, Kimihiko Masui, Takuma Sato, Takeshi
Sano, Takayuki Goto, Shusuke Akamatsu, Osamu Ogawa

Department of Urology, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan.
Correspondence to: Prof. Osamu Ogawa, Department of Urology, Kyoto University Graduate School of Medicine, 54, Syogoin
Kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan. E-mail: ogawao@kuhp.kyoto-u.ac.jp
How to cite this article: Sawada A, Kobayashi T, Takahashi T, Kono J, Masui K, Sato T, Sano T, Goto T, Akamatsu S, Ogawa O.
Comparative analysis of perioperative outcomes between robot-assisted partial nephrectomy and open partial nephrectomy: a
propensity-matched study. Mini-invasive Surg 2021;5:6. http://dx.doi.org/10.20517/2574-1225.2020.100

Received: 12 Oct 2020 First Decision: 10 Dec 2020 Revised: 16 Dec 2020 Accepted: 20 Jan 2021 Published: 3 Feb 2021
Academic Editor: Toshio Takagi Copy Editor: Yue-Yue Zhang Production Editor: Xi-Jun Chen

Abstract
Aim: Partial nephrectomy is the standard treatment for small renal tumors; however, it remains unclear which
surgical approach from among robot-assisted partial nephrectomy (RAPN) and open partial nephrectomy
(OPN) is superior. This study aimed to compare perioperative outcomes of RAPN and OPN performed at a single
institution after adjusting for preoperative patient and tumor characteristics using propensity score matching
(PSM).

Methods: In this retrospective cohort study, patients who underwent RAPN or OPN for a renal mass of cT1-2 N0
M0 between 2005 and 2020 at our institution were recruited. The study outcomes were perioperative outcomes,
complications, and pathological and functional outcomes. PSM was used to account for baseline covariates.

Results: Overall, 131 RAPN and 71 OPN cases were extracted; in addition, 58 cases of RAPN and OPN were
selected via PSM. RAPN was superior to OPN in terms of estimated blood loss (10 g vs. 160 g, P < 0.001), ischemia
time (23 min vs. 34 min, P < 0.001), and hospital duration (7 days vs. 12 days, P < 0.001). There were no significant
differences in the incidence of perioperative complications or in the rate of positive surgical margins (both P >
0.05). With respect to functional outcomes, the rates of preservation of renal function at both 1 day and 3 months
postoperatively were higher with RAPN than with OPN (85.3% vs. 69.1% and 93.3% vs. 85.6% respectively, both P < 0.001).

© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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