Comparison of Mortality and Morbidity of Robotic Versus Laparoscopic Radical Nephrectomy for the Treatment of Renal Cell Carcinoma—An Analysis of the National Surgery Quality Improvement Program (NSQIP) Targeted Nephrectomy Database
Objectives: To compare the perioperative complications between robot-assisted (RARN) and laparoscopic (LRN) radical nephrectomy for the treatment of renal cell carcinoma (RCC). Methods: We conducted a retrospective study using the National Surgical Quality Improvement Program (NSQIP) Nephrectomy-Tar...
Saved in:
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2025-06-01
|
| Series: | Current Oncology |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1718-7729/32/6/358 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849472294209978368 |
|---|---|
| author | Vatsala Mundra Siqi Hu Renil Sinu Titus Eusebio Luna-Velazquez Zachary Melchiode Jiaqiong Xu Carlos Riveros Sanjana Ranganathan Emily Huang Brian J. Miles Dharam Kaushik Christopher J. D. Wallis Raj Satkunasivam |
| author_facet | Vatsala Mundra Siqi Hu Renil Sinu Titus Eusebio Luna-Velazquez Zachary Melchiode Jiaqiong Xu Carlos Riveros Sanjana Ranganathan Emily Huang Brian J. Miles Dharam Kaushik Christopher J. D. Wallis Raj Satkunasivam |
| author_sort | Vatsala Mundra |
| collection | DOAJ |
| description | Objectives: To compare the perioperative complications between robot-assisted (RARN) and laparoscopic (LRN) radical nephrectomy for the treatment of renal cell carcinoma (RCC). Methods: We conducted a retrospective study using the National Surgical Quality Improvement Program (NSQIP) Nephrectomy-Targeted database from 2019 to 2021. After using propensity score matching, we assessed the association between LRN vs. RARN and the outcomes of interest (primary outcomes of 30-day mortality, return to the operating room, myocardial infarction, and stroke; and secondary outcomes of perioperative complications and nephrectomy-specific outcomes). Results: Among the 1545 patients in the study (mean age: 62.9 ± 11.8 years), 722 underwent RARN and 823 underwent LRN. We did not observe any differences in the major complications between the two approaches. However, LRN was associated with an increased chance of surgical site infections compared with RARN (LRN 2.68% vs. RARN 1.19%, <i>p</i> = 0.047). LRN was also associated with a higher likelihood of a prolonged length of stay (OR 1.54, 95% CI: 1.15, 2.06, <i>p</i> = 0.004) and had a 2.7 times higher chance of conversion rate to open surgery (OR 3.70, 95% CI: 3.25, 4.15, <i>p</i> < 0.001) relative to RARN. However, RARN was associated with a longer operative time than LRN (estimated coefficient 30.67, <i>p</i> < 0.001). Conclusion: We found no significant difference in the major complications between RARN and LRN for patients undergoing radical nephrectomy. At the expense of a somewhat longer operative time, RARN was associated with a lower risk of SSI and a lower conversion rate to open RN. LRN and RARN should both be considered and selected on an individualized basis using tumor, patient, and physician factors. |
| format | Article |
| id | doaj-art-e887e938dfae46cab46cda8699bb9b86 |
| institution | Kabale University |
| issn | 1198-0052 1718-7729 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj-art-e887e938dfae46cab46cda8699bb9b862025-08-20T03:24:34ZengMDPI AGCurrent Oncology1198-00521718-77292025-06-0132635810.3390/curroncol32060358Comparison of Mortality and Morbidity of Robotic Versus Laparoscopic Radical Nephrectomy for the Treatment of Renal Cell Carcinoma—An Analysis of the National Surgery Quality Improvement Program (NSQIP) Targeted Nephrectomy DatabaseVatsala Mundra0Siqi Hu1Renil Sinu Titus2Eusebio Luna-Velazquez3Zachary Melchiode4Jiaqiong Xu5Carlos Riveros6Sanjana Ranganathan7Emily Huang8Brian J. Miles9Dharam Kaushik10Christopher J. D. Wallis11Raj Satkunasivam12Department of Urology, Houston Methodist Hospital, Houston, TX 77030, USADepartment of Urology, Houston Methodist Hospital, Houston, TX 77030, USADepartment of Urology, Houston Methodist Hospital, Houston, TX 77030, USADepartment of Urology, Houston Methodist Hospital, Houston, TX 77030, USADepartment of Urology, Houston Methodist Hospital, Houston, TX 77030, USACenter for Health Data Science and Analytics, Houston Methodist Research Institute, Houston, TX 77030, USADepartment of Urology, Houston Methodist Hospital, Houston, TX 77030, USADepartment of Urology, Houston Methodist Hospital, Houston, TX 77030, USADepartment of Urology, Houston Methodist Hospital, Houston, TX 77030, USADepartment of Urology, Houston Methodist Hospital, Houston, TX 77030, USADepartment of Urology, Houston Methodist Hospital, Houston, TX 77030, USADivision of Urology and Surgical Oncology, Department of Surgery, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5S 1A1, CanadaDepartment of Urology, Houston Methodist Hospital, Houston, TX 77030, USAObjectives: To compare the perioperative complications between robot-assisted (RARN) and laparoscopic (LRN) radical nephrectomy for the treatment of renal cell carcinoma (RCC). Methods: We conducted a retrospective study using the National Surgical Quality Improvement Program (NSQIP) Nephrectomy-Targeted database from 2019 to 2021. After using propensity score matching, we assessed the association between LRN vs. RARN and the outcomes of interest (primary outcomes of 30-day mortality, return to the operating room, myocardial infarction, and stroke; and secondary outcomes of perioperative complications and nephrectomy-specific outcomes). Results: Among the 1545 patients in the study (mean age: 62.9 ± 11.8 years), 722 underwent RARN and 823 underwent LRN. We did not observe any differences in the major complications between the two approaches. However, LRN was associated with an increased chance of surgical site infections compared with RARN (LRN 2.68% vs. RARN 1.19%, <i>p</i> = 0.047). LRN was also associated with a higher likelihood of a prolonged length of stay (OR 1.54, 95% CI: 1.15, 2.06, <i>p</i> = 0.004) and had a 2.7 times higher chance of conversion rate to open surgery (OR 3.70, 95% CI: 3.25, 4.15, <i>p</i> < 0.001) relative to RARN. However, RARN was associated with a longer operative time than LRN (estimated coefficient 30.67, <i>p</i> < 0.001). Conclusion: We found no significant difference in the major complications between RARN and LRN for patients undergoing radical nephrectomy. At the expense of a somewhat longer operative time, RARN was associated with a lower risk of SSI and a lower conversion rate to open RN. LRN and RARN should both be considered and selected on an individualized basis using tumor, patient, and physician factors.https://www.mdpi.com/1718-7729/32/6/358renal cell carcinomaradical nephrectomylaparoscopic surgeryrobot-assisted surgery |
| spellingShingle | Vatsala Mundra Siqi Hu Renil Sinu Titus Eusebio Luna-Velazquez Zachary Melchiode Jiaqiong Xu Carlos Riveros Sanjana Ranganathan Emily Huang Brian J. Miles Dharam Kaushik Christopher J. D. Wallis Raj Satkunasivam Comparison of Mortality and Morbidity of Robotic Versus Laparoscopic Radical Nephrectomy for the Treatment of Renal Cell Carcinoma—An Analysis of the National Surgery Quality Improvement Program (NSQIP) Targeted Nephrectomy Database Current Oncology renal cell carcinoma radical nephrectomy laparoscopic surgery robot-assisted surgery |
| title | Comparison of Mortality and Morbidity of Robotic Versus Laparoscopic Radical Nephrectomy for the Treatment of Renal Cell Carcinoma—An Analysis of the National Surgery Quality Improvement Program (NSQIP) Targeted Nephrectomy Database |
| title_full | Comparison of Mortality and Morbidity of Robotic Versus Laparoscopic Radical Nephrectomy for the Treatment of Renal Cell Carcinoma—An Analysis of the National Surgery Quality Improvement Program (NSQIP) Targeted Nephrectomy Database |
| title_fullStr | Comparison of Mortality and Morbidity of Robotic Versus Laparoscopic Radical Nephrectomy for the Treatment of Renal Cell Carcinoma—An Analysis of the National Surgery Quality Improvement Program (NSQIP) Targeted Nephrectomy Database |
| title_full_unstemmed | Comparison of Mortality and Morbidity of Robotic Versus Laparoscopic Radical Nephrectomy for the Treatment of Renal Cell Carcinoma—An Analysis of the National Surgery Quality Improvement Program (NSQIP) Targeted Nephrectomy Database |
| title_short | Comparison of Mortality and Morbidity of Robotic Versus Laparoscopic Radical Nephrectomy for the Treatment of Renal Cell Carcinoma—An Analysis of the National Surgery Quality Improvement Program (NSQIP) Targeted Nephrectomy Database |
| title_sort | comparison of mortality and morbidity of robotic versus laparoscopic radical nephrectomy for the treatment of renal cell carcinoma an analysis of the national surgery quality improvement program nsqip targeted nephrectomy database |
| topic | renal cell carcinoma radical nephrectomy laparoscopic surgery robot-assisted surgery |
| url | https://www.mdpi.com/1718-7729/32/6/358 |
| work_keys_str_mv | AT vatsalamundra comparisonofmortalityandmorbidityofroboticversuslaparoscopicradicalnephrectomyforthetreatmentofrenalcellcarcinomaananalysisofthenationalsurgeryqualityimprovementprogramnsqiptargetednephrectomydatabase AT siqihu comparisonofmortalityandmorbidityofroboticversuslaparoscopicradicalnephrectomyforthetreatmentofrenalcellcarcinomaananalysisofthenationalsurgeryqualityimprovementprogramnsqiptargetednephrectomydatabase AT renilsinutitus comparisonofmortalityandmorbidityofroboticversuslaparoscopicradicalnephrectomyforthetreatmentofrenalcellcarcinomaananalysisofthenationalsurgeryqualityimprovementprogramnsqiptargetednephrectomydatabase AT eusebiolunavelazquez comparisonofmortalityandmorbidityofroboticversuslaparoscopicradicalnephrectomyforthetreatmentofrenalcellcarcinomaananalysisofthenationalsurgeryqualityimprovementprogramnsqiptargetednephrectomydatabase AT zacharymelchiode comparisonofmortalityandmorbidityofroboticversuslaparoscopicradicalnephrectomyforthetreatmentofrenalcellcarcinomaananalysisofthenationalsurgeryqualityimprovementprogramnsqiptargetednephrectomydatabase AT jiaqiongxu comparisonofmortalityandmorbidityofroboticversuslaparoscopicradicalnephrectomyforthetreatmentofrenalcellcarcinomaananalysisofthenationalsurgeryqualityimprovementprogramnsqiptargetednephrectomydatabase AT carlosriveros comparisonofmortalityandmorbidityofroboticversuslaparoscopicradicalnephrectomyforthetreatmentofrenalcellcarcinomaananalysisofthenationalsurgeryqualityimprovementprogramnsqiptargetednephrectomydatabase AT sanjanaranganathan comparisonofmortalityandmorbidityofroboticversuslaparoscopicradicalnephrectomyforthetreatmentofrenalcellcarcinomaananalysisofthenationalsurgeryqualityimprovementprogramnsqiptargetednephrectomydatabase AT emilyhuang comparisonofmortalityandmorbidityofroboticversuslaparoscopicradicalnephrectomyforthetreatmentofrenalcellcarcinomaananalysisofthenationalsurgeryqualityimprovementprogramnsqiptargetednephrectomydatabase AT brianjmiles comparisonofmortalityandmorbidityofroboticversuslaparoscopicradicalnephrectomyforthetreatmentofrenalcellcarcinomaananalysisofthenationalsurgeryqualityimprovementprogramnsqiptargetednephrectomydatabase AT dharamkaushik comparisonofmortalityandmorbidityofroboticversuslaparoscopicradicalnephrectomyforthetreatmentofrenalcellcarcinomaananalysisofthenationalsurgeryqualityimprovementprogramnsqiptargetednephrectomydatabase AT christopherjdwallis comparisonofmortalityandmorbidityofroboticversuslaparoscopicradicalnephrectomyforthetreatmentofrenalcellcarcinomaananalysisofthenationalsurgeryqualityimprovementprogramnsqiptargetednephrectomydatabase AT rajsatkunasivam comparisonofmortalityandmorbidityofroboticversuslaparoscopicradicalnephrectomyforthetreatmentofrenalcellcarcinomaananalysisofthenationalsurgeryqualityimprovementprogramnsqiptargetednephrectomydatabase |