Comparison of robotic and laparoscopic partial nephrectomy in the management of solitary kidney tumors: a retrospective single-center study (2012-2025).

OBJECTIVES

Assess the clinical effectiveness of robotic versus standard laparoscopic partial nephrectomy in treating solitary renal tumors.

METHODS

We retrospectively analyzed data from those who underwent laparoscopic (LPN, n = 28) or robot-assisted partial nephrectomy (RAPN, n = 16) at our institution between September 2012 and September 2024. Comparisons included demographics, R.E.N.A.L. scores (validated for tumor complexity), perioperative metrics (warm ischemia time, blood loss, complications), and follow-up (renal function, recurrence).

RESULTS

RAPN had significantly shorter operative time and drainage duration, with fewer complications (2 vs. 8 in LPN); 1 LPN case converted to open. All margins were negative, with clear cell carcinoma (70.45%) most common. All patients had a follow-up period of more than 6 years. Five-year overall survival: 93.75% (RAPN) vs. 89.3% (LPN). Renal function changes (sCr, GFR) did not differ significantly, with no dialysis needed.Both approaches are safe; RAPN offers better operative efficiency and recovery.

CONCLUSIONS

RAPN and LPN are both reliable minimally invasive techniques for managing solitary kidney tumors. Although RAPN tended to achieve shorter operative, ischemia, and drainage times, these differences were not statistically significant. In cases of complex renal lesions with higher R.E.N.A.L. scores, RAPN may offer technical advantages. Larger, multicenter prospective studies with extended follow-up are needed to substantiate these observations.