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LETTER TO EDITOR
Year : 2023  |  Volume : 39  |  Issue : 1  |  Page : 80-81
 

Author Reply Re: Sharma G, Shah M, Ahluwalia P, Dasgupta P, Challacombe BJ, Bhandari M, et al. Perioperative outcomes following robot-assisted partial nephrectomy for complex renal masses: A Vattikuti Collective Quality Initiative database study. Indian J Urol 2022;38:288-95


Department of Urologic Oncology, Max Institute of Cancer Care, New Delhi, India

Date of Submission06-Nov-2022
Date of Acceptance01-Dec-2022
Date of Web Publication29-Dec-2022

Correspondence Address:
Gagan Gautam
Department of Urologic Oncology, Max Institute of Cancer Care, New Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/iju.iju_393_22

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How to cite this article:
Sharma G, Ahluwalia P, Gautam G. Author Reply Re: Sharma G, Shah M, Ahluwalia P, Dasgupta P, Challacombe BJ, Bhandari M, et al. Perioperative outcomes following robot-assisted partial nephrectomy for complex renal masses: A Vattikuti Collective Quality Initiative database study. Indian J Urol 2022;38:288-95. Indian J Urol 2023;39:80-1

How to cite this URL:
Sharma G, Ahluwalia P, Gautam G. Author Reply Re: Sharma G, Shah M, Ahluwalia P, Dasgupta P, Challacombe BJ, Bhandari M, et al. Perioperative outcomes following robot-assisted partial nephrectomy for complex renal masses: A Vattikuti Collective Quality Initiative database study. Indian J Urol 2022;38:288-95. Indian J Urol [serial online] 2023 [cited 2023 Jan 30];39:80-1. Available from: https://www.indianjurol.com/text.asp?2023/39/1/80/365901


We read with great interest the “letter to the editor” on our article published in the October–December 2022 issue of the Indian Journal of Urology.[1] We would like to thank the authors for their kind comments and for showing interest in our study. In their “letter to the editor”, authors have reiterated the previously mentioned limitations of the Vattikuti Collective Quality Initiative (VCQI) database in the original study such as those related to hilar location, endophytic tumors, and surgeon factors.[1] The template used for VCQI robot-assisted partial nephrectomy (RAPN) database has been employed since 2014 without any update. Contemporarily, the database has multiple limitations which have been adequately highlighted in the present and previous studies.[2],[3],[4] Efforts are being made to update the database to the current standard of scientific reasoning.

Presenting the data of individual centers (18) would be a cumbersome task in our opinion without any clear advantage. However, to this end, a study specifically looking at perioperative outcomes of the RAPN in the Indian subset of the population from the VCQI database has been done and is currently under the peer review process. Regarding performing propensity-matched analysis. This study was largely a descriptive study and did not involve comparative arms. We had performed propensity matching in our previous studies with comparative arms.[3],[5] Therefore, in our opinion due to the descriptive nature and lack of comparative arms, there is no need for propensity analysis in the present study.

Finally, we agree with the author's comment that one cutoff of warm ischemia time used may not be appropriate to define trifecta. We would like to point out that there are multiple definitions of trifecta using different cutoffs for the WIT in the literature. The one used in the present study is a widely accepted one and has been adequately cited in the text. We did not perform a regression analysis of individual factors of the PADUA score for two reasons. First, as rightly pointed out by the authors, it has been previously performed by other authors using the same database. Therefore, performing it again would have been a futile effort. Second, it was not the primary or even secondary objective of this study to study the impact of individual factors of the PADUA score on perioperative outcomes.

Financial support and sponsorship: Nil.

Conflicts of interest: There are no conflicts of interest.

 
   References Top

1.
Sharma G, Shah M, Ahluwalia P, Dasgupta P, Challacombe B, Bhandari M, et al. Perioperative outcomes following robot-assisted partial nephrectomy for complex renal masses: A Vattikuti Collective Quality Initiative database study. Indian J Urol 2022;38:288-95.  Back to cited text no. 1
  [Full text]  
2.
Sharma G, Shah M, Ahluwalia P, Dasgupta P, Challacombe BJ, Bhandari M, et al. Development and validation of a nomogram predicting intraoperative adverse events during robot-assisted partial nephrectomy. Eur Urol Focus 2022:S2405-7.  Back to cited text no. 2
    
3.
Sharma G, Shah M, Ahluwalia P, Dasgupta P, Challacombe BJ, Bhandari M, et al. Comparison of perioperative outcomes following transperitoneal versus retroperitoneal robot-assisted partial nephrectomy: A propensity-matched analysis of VCQI database. World J Urol 2022;40:2283-91.  Back to cited text no. 3
    
4.
Sharma G, Shah M, Ahluwalia P, Dasgupta P, Challacombe BJ, Bhandari M, et al. Perioperative outcomes following robot-assisted partial nephrectomy in elderly patients. World J Urol 2022;40:2789-98.  Back to cited text no. 4
    
5.
Tyagi S, Sharma G, Bora GS, Mavuduru RS, Sharma AP, Devana SK, et al. Trifecta and pentafecta outcomes following robot-assisted partial nephrectomy for hilar versus nonhilar tumors: A propensity-matched analysis. Indian J Urol 2021;37:318-24.  Back to cited text no. 5
  [Full text]  




 

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