Comparison studies of "Ultra-thin parenchyma" resection and sharp dissection in robotic partial nephrectomy for renal tumors.

Objective: The aim of this study was to introduce the "ultrathin parenchyma" resection in a robot-assisted partial nephrectomy (RAPN) via the retroperitoneal approach, and to assess the feasibility, security, and effectiveness of this technique. Methods: We collected and retrospectively reviewed the clinical data of patients with renal tumors who underwent ultrathin parenchyma resections in RAPNs via the retroperitoneal approach or traditional sharp dissection in RAPNs via the retroperitoneal approach from February 2015 to August 2018. The general data and other parameters, such as the operation time, blood loss (BL), warm ischemia time (WIT), positive surgical margin (PSM), glomerular filtration rate (GFR), and postoperative recurrence, were compared and analyzed between the two surgical techniques. Results: In ultrathin parenchyma resection groups, one case was converted to an open surgery, while the other cases were completed effectively. There were no significant differences in the general data, operation time, intraoperative BL, WIT, intraoperative complications, transfusion rate, PSM rate, hospital stay, and recurrence rate after the operation between the two groups (p > 0.05). The postoperative residual kidney volume percentage and the GFR (6 months postoperatively) were significantly higher in the ultrathin parenchyma resection group when compared with the traditional sharp dissection group (p < 0.05). Conclusion: The ultrathin parenchyma resection during robotic partial nephrectomy (RPN) is a safe and effective surgical technique for the resection of cT1 renal tumors. It can preserve the renal function under the premise of ensuring effective tumor control.