Mahesh Desai
Background: We summarise our experience with RPN emphasising on learning curve, techniques and outcomes.
Patients and methods: A retrospective chart review of 241 patients was done. The parameters analyzed were demographics, tumor characteristics, operative details, postoperative outcome and follow-up.
Results: 243 renal units in 241 patients (64 males and 177 females) underwent RAPN. The mean age was 51.48 (18-83) years. The mean tumor size was 5.92 (1.3-11.5) cm. operative time was 176.97 (70-350) min.; mean warm ischemia time was 22.62min (0-47). 8 renal units in 7patients were operated with the zero ischemia There was 1 recurrence. The average nephrometry score was 6.77. The complications were Clavien grade 1 (n=5, Fever), Clavien grade 3 (n=5, 2-need for exploration & 3 need for post-operative intervention for urine leak), Clavien grade 5 (n=1), immediate post-operative myocardial infarction). 6 patients developed chronic kidney disease over a period of 10 years. eGFR trend was preoperative 101.25 (17.9-182.4), 1 month 88.30 (0.69-177.4), 1 years 99.71 (11.3-167).
Conclusion: Our results suggest that RAPN is safe. RAPN offers excellent oncologic control and disease free status in long-term follow up. Nephrometry score is a good tool to predict the challenges anticipated during surgery. RAPN helps in preserving the renal function in long term.
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