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    Long-term outcomes of minimally invasive surgeries in partial nephrectomy. Robot or laparoscopy?
    (Wiley, 2021) Boga, Mehmet Salih; Sonmez, Mehmet Giray; Karamik, Kaan; Ozsoy, Cagatay; Aydin, Arif; Savas, Murat; Ates, Mutlu
    Background To compare long-term oncological and renal functional outcomes of laparoscopic and robotic partial nephrectomy for small renal masses. Methods A total of 103 patients who underwent laparoscopic (n = 31) and robotic (n = 72) partial nephrectomy between April 2015 and November 2018 were included in the study. Perioperative parameters, long-term oncological and functional outcomes were compared between the laparoscopic and robotic groups. Results No significant differences were found in terms of age, tumour size, RENAL and PADUA scores, pre-operative estimated glomerular filtration rate (eGFR), and presence of chronic hypertension and diabetes (P = .479, P = .199, P = .120 and P = .073, P = .561, and P = .082 and P = .518, respectively). Only estimated blood loss was significantly higher in the laparoscopic group in operative parameters (158.23 +/- 72.24 mL vs. 121.11 +/- 72.17 mL; P = .019), but transfusion rates were similar between the groups (P = .33). In the laparoscopic group, two patients (6.5%) required conversion to open, while no conversion was needed in the robotic group (P = .89). There were no differences in terms of positive surgical margin and complication rates (P = .636 and P = .829, respectively). No significant differences were observed in eGFR changes and post-operative new-onset chronic kidney disease at 1 year after the surgery (P = .768, P = .614, respectively). The overall mean follow-up period was 36.07 +/- 13.56 months (P = .007). During the follow-up period, no cancer-related death observed in both group and non-cancer-specific survival was 93.5% and 94.4% in laparoscopic and robotic groups, respectively (P = .859). Conclusions In this study, perioperative and long-term oncological and functional outcomes seems to be comparable between laparoscopic and robotic partial nephrectomies.
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    Single-center experience of robot-assisted radical cystectomy (RARC) and extended pelvic lymph node dissection
    (Aves, 2020) Boga, Mehmet Salih; Ozsoy, Cagatay; Aktas, Yasin; Aydin, Arif; Savas, Murat; Ates, Mutlu
    Objective: To report the outcomes of robot-assisted radical cystectomy (RARC) and extended pelvic lymph node dissection (ePLND) series for bladder cancer. Material and methods: Between October 2016 and June 2019, overall 57 patients (50 men, 7 women) were included in the study. Patient demographics, operative data, and postoperative pathological outcomes were evaluated. Patients who had a history of pelvic or intraabdominal surgery due to other concurrent malignancy, radiation therapy, or lacked data were excluded from the study. Results: The mean age of the patients was 64.72 +/- 9.09 years. The mean operation time, intraoperative estimated blood loss, and hospitalization time were 418.58 +/- 85.66 minutes, 313.00 +/- 79.16mL, and 13.44 +/- 5.25 days, respectively. The postoperative pathological stages were reported as pT0 (n=8), pTis (n=4), pT1 (n=4), pT2 (n=22), pT3a (n=11), pT3b (n=2), pT4a (n=4), pT4b (n=1), and other (n=1). The mean lymph node (LN) yield was 23.45 +/- 943. Positive LNs were found in 16 (28.1%) patients. Surgical margins were positive in 3 (5.26%) patients. The mean follow-up period was 15.42 +/- 8.31 months. According to the modified Clavien-Dindo system, minor (Clavien 1-2) and major (Clavien 3-5) complications occurred in 18 (31.58%) and 9 (15.78%) patients during the early (0-30 days) period and in 4 (7.02%) and 5 (8.77%) patients in the late (31-90 days) period. Conclusion: RARC and ePLND are complex but safe procedures with acceptable morbidity and excellent surgical and oncologic outcomes in muscle-invasive or high-risk bladder tumors.