The State of Robotic Partial Nephrectomy: Operative, Functional, and Oncological Outcomes From A Robust Multi-Institution Collaborative.

OBJECTIVE: To describe the most recent surgical, functional, and oncological outcomes of RPN utilizing one of the largest, prospectively maintained, multi-institution consortium of patients undergoing robotic renal surgery. MATERIALS AND METHODS: Data was obtained from a prospectively maintained multi-institutional database of patients who underwent RPN for clinically localized kidney cancer between 2018 and 2022 by 9 high-volume surgeons. Demographic and tumor characteristics as well as operative, functional, and oncological outcomes were queried. RESULTS: A total of 2836 patients underwent RPN. Intraoperative, postoperative, and 30-day major complication rates were 2.68%, 11.39%, and 3.24%, respectively. Median tumor size was 3.0 cm. Tumors with low complexity had a shorter median operative time, lower median EBL, shorter median ischemia time, lower postoperative complication rate, and lower decline in renal function There was no significant difference between tumor complexities with respect to the rate of conversion to radical nephrectomy, conversion to open, major complications, and positive margins. Lower BMI, smaller clinical tumor size, lower tumor complexity, and higher baseline eGFR were significantly associated with trifecta achievement. CONCLUSION: Patient BMI, baseline eGFR, and tumor characteristics such as size and complexity are the most important predictors of trifecta achievement. Patients with complex tumors should be counseled that they are at increased risk of complications and worsening renal function after robotic partial nephrectomy.

Is YouTube a good resource for patients to better understand kidney cancer?

OBJECTIVE: To assesses the complexity, reliability, and quality of the most popular kidney cancer videos on YouTube. METHODS: We searched YouTube using phrases relevant to kidney cancer and grouped videos based on publishing channel type. Video parameters along with complexity, reliability, and quality scores were recorded. Video complexity was determined using the SMOG index. SMOG scores greater than 6.4 equate to content that is too complex for the general public. Video quality and reliability was scored by 5 reviewers using the Global Quality Scale and a modified DISCERN criteria. All categorical and numerical variables were analyzed via independent t-test and 1-way analysis of variance using SPSS. RESULTS: One hundred twenty-one videos were analyzed. The most popular publishing channel types are professional development (n = 65), medical institutions (n = 27), student education (n = 9), and nonprofit organization (n = 4). Professional development videos are significantly more complex than medical institution videos (mean SMOG score of 11.1 vs. 9.4, P = 0.004), and nonprofit organization videos (11.1 vs. 7.8, P = 0.003). Compared to medical institution videos, professional development videos have fewer mean total views (876 views vs. 17,554, P = 0.016), mean views per month (14.92 views vs. 351.7, P = 0.007), and mean comments (1 comment vs. 18, P = 0.038). Both professional development videos and medical institution videos are more reliable than student education videos (mean DISCERN score of 3.9 vs. 2.9, P < 0.001). CONCLUSION: There is a lack of understandable and reliable kidney cancer videos on YouTube. Moreover, the majority of kidney cancer videos are intended for medical professionals and may be too complex for the general public. The medical community has the opportunity to make an active effort to provide better resources for patients on YouTube.