Indian Journal of Urology
ORIGINAL ARTICLE
Year
: 2021  |  Volume : 37  |  Issue : 4  |  Page : 318--324

Trifecta and pentafecta outcomes following robot-assisted partial nephrectomy for hilar versus nonhilar tumors: A propensity-matched analysis


Shantanu Tyagi1, Gopal Sharma1, Girdhar S Bora1, Ravimohan S Mavuduru1, Aditya Prakash Sharma1, Sudheer Kumar Devana1, Ujjwal Gorsi2, Nandita Kakkar3, Shrawan K Singh1 
1 Department of Urology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
2 Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, India
3 Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Correspondence Address:
Ravimohan S Mavuduru
Department of Urology, Postgraduate Institute of Medical Education and Research, Chandigarh
India

Introduction: Hilar tumors are a unique subset of complex renal masses posing a potential surgical challenge during partial nephrectomy. The outcomes of hilar masses have not been compared to non-hilar renal masses of similar RENAL nephrometry score (RNS). In this study, we analyzed the outcomes of hilar versus nonhilar masses after a propensity score matching. Methods: Prospectively maintained database of patients who underwent robot assisted PN between November 2014 and December 2018 was abstracted for hilar and nonhilar tumors. We performed propensity matching for baseline variables such as age, sex, body mass index, comorbidities, preoperative glomerular filtration rate, and RNS for each patient on the basis of propensity scores. Results: We included 48 patients with hilar tumors and 153 with nonhilar tumors. On propensity matching, 41 patients were included in each group. The mean operative time (162.4 ± 48.9 min vs. 144.1 ± 38.8 min, P = 0.48), warm ischemia time (29.0 ± 8.8 min vs. 24.4 ± 8.2 min, P = 0.12), and the estimated blood loss (201.8 ± 184.7 ml vs. 150.6 ± 160.5 ml, P = 0.37) were not significantly different between the hilar and the nonhilar groups. Trifecta was achieved in only 14/41 (34.1%) of the patients in the hilar group as compared to 24/41 (58.5%) in the nonhilar group (P = 0.027). Logistic regression analysis identified that hilar location of the tumors was not an independent predictor of overall complications (OR 6.37, confidence interval [CI] 0.5–69.4, P = 0.4), trifecta (OR 0.38, CI 0.14–1.0, P = 0.051), and pentafecta outcomes (OR 0.4, CI 0.1–1.51, P = 0.17). Conclusions: Hilar location was associated with poorer trifecta outcomes compared to the nonhilar tumors. However, hilar location per se was not an independent predictor of overall complications and trifecta and pentafecta outcomes.


How to cite this article:
Tyagi S, Sharma G, Bora GS, Mavuduru RS, Sharma AP, Devana SK, Gorsi U, Kakkar N, Singh SK. Trifecta and pentafecta outcomes following robot-assisted partial nephrectomy for hilar versus nonhilar tumors: A propensity-matched analysis.Indian J Urol 2021;37:318-324


How to cite this URL:
Tyagi S, Sharma G, Bora GS, Mavuduru RS, Sharma AP, Devana SK, Gorsi U, Kakkar N, Singh SK. Trifecta and pentafecta outcomes following robot-assisted partial nephrectomy for hilar versus nonhilar tumors: A propensity-matched analysis. Indian J Urol [serial online] 2021 [cited 2021 Oct 18 ];37:318-324
Available from: https://www.indianjurol.com/article.asp?issn=0970-1591;year=2021;volume=37;issue=4;spage=318;epage=324;aulast=Tyagi;type=0