Outcomes and limitations of laparoscopic and robotic partial nephrectomy

摘要

PURPOSE OF REVIEW: The objective of this review article is to summarize and critically analyze the studies published in the previous year and report perioperative, functional, and oncologic outcomes after laparoscopic partial nephrectomy (LPN) and robot-assisted partial nephrectomy (RAPN). RECENT FINDINGS: Recent case series studies evaluating LPN confirmed the good oncologic results of this approach at intermediate and long-term follow-ups. Recent studies investigating RAPN confirmed the promising perioperative outcomes reported in the initial case series. Many studies tested and demonstrated the feasibility of both procedures in the treatment of very complex cases represented by tumors larger than 4 cm, hilar/central tumors, endophytic tumors, or tumors located in solitary kidney. Comparative studies confirm advantages in favor of RAPN in comparison with LPN, mainly in terms of warm ischemia time and perioperative outcomes. A recent matched pair analysis showed equivalent perioperative and functional outcomes between RAPN and open partial nephrectomy (OPN). SUMMARY: LPN and above all RAPN represent valid alternatives to OPN in the conservative treatment of renal tumors. Both procedures can be proposed also for the treatment of complex cases. Further, well conducted, comparative studies between RAPN and OPN are needed to test the ability of RAPN as an alternative to OPN in the treatment of more complex cases.