Robotic and open partial nephrectomy for tumors in a solitary kidney

Zain A. Abedali, M. Francesca Monn, Brent E. Cleveland, Jay Sulek, Clinton D. Bahler, Michael O. Koch, Richard Bihrle, Timothy A. Masterson, Thomas A. Gardner, Ronald S. Boris, Chandru P. Sundaram

Research output: Contribution to journalArticle


Introduction and objective: Traditionally, patients with renal masses in solitary kidneys were managed with an open partial nephrectomy. With improving techniques, robotic-assisted partial nephrectomy in the setting of a solitary kidney is increasingly utilized. The objective of this study was to compare open partial nephrectomy and robotic-assisted partial nephrectomy outcomes in solitary kidney patients. Methods: A retrospective study of 536 total patients who underwent partial nephrectomy between 2004–2016 was performed. Of these patients, 23 had a renal mass in a solitary kidney. Patient demographics, perioperative values, and surgical outcomes were analyzed using descriptive statistics to compare open partial nephrectomy to robotic-assisted partial nephrectomy. Results: Of the 23 patients in the cohort, 52% (n=12) underwent open partial nephrectomy and 48% (n=11) underwent robotic-assisted partial nephrectomy. Patient characteristics were not significantly different. The mean (standard deviation) nephrometry score was 6.9 (1.8) for open partial nephrectomy and 6.1 (1.9) for robotic-assisted partial nephrectomy (p=0.290). The mean (standard deviation) pre-operative creatinine was 1.2 (0.3) in open partial nephrectomy and 1.5 (0.4) in robotic-assisted partial nephrectomy, which did not reach statistical significance (p=0.110). No difference in postoperative kidney function, Clavien grade 3 or higher complication rate, blood loss, or hospitalization length was noted. Conclusion: Although traditionally patients with a tumor in a solitary kidney are counseled to undergo open partial nephrectomy, robotic-assisted partial nephrectomy is a safe alternative with no decrease in postoperative renal function when compared with a similar cohort of patients undergoing open partial nephrectomy in a solitary kidney. Level of evidence: Level II.

Original languageEnglish (US)
JournalJournal of Clinical Urology
StateAccepted/In press - Jan 1 2020


  • Solitary kidney
  • partial nephrectomy
  • robotic surgery

ASJC Scopus subject areas

  • Surgery
  • Urology

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