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Comparison of postoperative pain between laparoscopic and robot-assisted partial nephrectomies for renal tumors: A propensity score matching analysis.

Abstract Robot-assisted partial nephrectomy (RAPN) has emerged as an alternative to laparoscopic partial nephrectomy (LPN) for removal of renal tumors. Several advantages of robotic surgery have been reported, but there is no comparative study on postoperative pain between the 2 techniques. Therefore, we compared the postoperative numerical rating scale (NRS) of pain intensity between patients who underwent LPN and those who underwent RAPN.We included 705 patients who underwent either LPN (n = 200) or RAPN (n = 505) for renal tumors between January 2000 and September 2016. After 1:1 propensity score matching, the final analysis included 142 patients each in the LPN and RAPN groups. The primary endpoint was postoperative NRS of pain intensity. The secondary endpoints were opioid requirement, opioid-related complications, and duration of hospital stay.Preoperative and intraoperative values of propensity score matched patients (n = 284) were not significantly different between the LPN and RAPN groups. There was no significant difference in NRS of pain intensity between the 2 groups. Opioid requirement was different between the 2 groups on postoperative day (POD) 0 (12.4 vs 11.3 mg of morphine-equivalent dose), but not from POD 1 to POD 4. The incidence of opioid-related complications and duration of hospital stay were not significantly different between the 2 groups.Postoperative pain was not significantly different between patients who underwent RAPN and those who underwent LPN. This result provides a potentially useful knowledge of postoperative pain characteristics in RAPN and LPN.
PMID
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Propensity-score matched analysis comparing robot-assisted with laparoscopic partial nephrectomy.

Authors

Mayor MeshTerms

Laparoscopy

Nephrectomy

Pain, Postoperative

Robotic Surgical Procedures

Keywords
Journal Title medicine
Publication Year Start




PMID- 28723795
OWN - NLM
STAT- MEDLINE
DA  - 20170720
DCOM- 20170808
LR  - 20170808
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 29
DP  - 2017 Jul
TI  - Comparison of postoperative pain between laparoscopic and robot-assisted partial 
      nephrectomies for renal tumors: A propensity score matching analysis.
PG  - e7581
LID - 10.1097/MD.0000000000007581 [doi]
AB  - Robot-assisted partial nephrectomy (RAPN) has emerged as an alternative to
      laparoscopic partial nephrectomy (LPN) for removal of renal tumors. Several
      advantages of robotic surgery have been reported, but there is no comparative
      study on postoperative pain between the 2 techniques. Therefore, we compared the 
      postoperative numerical rating scale (NRS) of pain intensity between patients who
      underwent LPN and those who underwent RAPN.We included 705 patients who underwent
      either LPN (n = 200) or RAPN (n = 505) for renal tumors between January 2000 and 
      September 2016. After 1:1 propensity score matching, the final analysis included 
      142 patients each in the LPN and RAPN groups. The primary endpoint was
      postoperative NRS of pain intensity. The secondary endpoints were opioid
      requirement, opioid-related complications, and duration of hospital
      stay.Preoperative and intraoperative values of propensity score matched patients 
      (n = 284) were not significantly different between the LPN and RAPN groups. There
      was no significant difference in NRS of pain intensity between the 2 groups.
      Opioid requirement was different between the 2 groups on postoperative day (POD) 
      0 (12.4 vs 11.3 mg of morphine-equivalent dose), but not from POD 1 to POD 4. The
      incidence of opioid-related complications and duration of hospital stay were not 
      significantly different between the 2 groups.Postoperative pain was not
      significantly different between patients who underwent RAPN and those who
      underwent LPN. This result provides a potentially useful knowledge of
      postoperative pain characteristics in RAPN and LPN.
FAU - Jin, Seok-Joon
AU  - Jin SJ
AD  - aDepartment of Anesthesiology and Pain Medicine bDepartment of Urology, Asan
      Medical Center, University of Ulsan College of Medicine, Seoul, Republic of
      Korea.
FAU - Park, Jun-Young
AU  - Park JY
FAU - Kim, Doo-Hwan
AU  - Kim DH
FAU - Yoon, Syn-Hae
AU  - Yoon SH
FAU - Kim, Eunkyul
AU  - Kim E
FAU - Hwang, Jai-Hyun
AU  - Hwang JH
FAU - Song, Cheryn
AU  - Song C
FAU - Kim, Young-Kug
AU  - Kim YK
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Analgesics, Opioid)
SB  - AIM
SB  - IM
MH  - Analgesics, Opioid/therapeutic use
MH  - Female
MH  - Humans
MH  - Kidney Neoplasms/*surgery
MH  - *Laparoscopy/methods
MH  - Length of Stay
MH  - Male
MH  - Middle Aged
MH  - *Nephrectomy/methods
MH  - Operative Time
MH  - Pain Measurement
MH  - *Pain, Postoperative/drug therapy
MH  - Propensity Score
MH  - Retrospective Studies
MH  - *Robotic Surgical Procedures/methods
PMC - PMC5521935
EDAT- 2017/07/21 06:00
MHDA- 2017/08/09 06:00
CRDT- 2017/07/21 06:00
AID - 10.1097/MD.0000000000007581 [doi]
AID - 00005792-201707210-00060 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Jul;96(29):e7581. doi: 10.1097/MD.0000000000007581.