49 Archivio Italiano di Urologia e Andrologia 2015; 87, 1 ORIGINAL PAPER Evaluation of laparoscopic vs robotic partial nephrectomy using the margin, ischemia and complications score system: A retrospective single center analysis Stefano Ricciardulli 1, 2 , Qiang Ding 1 , Xu Zhang 1 , Hongzhao Li 1 , Yuzhe Tang 1 , Guoqiang Yang 1 , Xiyou Wang 1 , Xin Ma 1 , Alberto Breda 3 , Antonio Celia 2 1 Department of Urology, Chinese PLA General Hospital, Beijing, China; 2 Department of Urology, San Bassiano Hospital, Bassano Del Grappa, Italy; 3 Department of Urology, Foundacio Puigvert Universidad Autonoma de Barcelona, Spain. Objective: To evaluate differences between Laparoscopic Partial Nephrectomy (LPN) and Robot-Assisted Partial Nephrectomy (RAPN) using the Margin, Ischemia and Complications (MIC) score system and to evaluate factors related with MIC success. Materials and Methods: Single centre retrospective study on 258 LPN and 58 RAPN performed between January 2012 and January 2014. Success was defined when surgi- cal margins was negative, Warm Ischemia Time (WIT) was ≤ 20 minutes and no major complications occurred. Mann-Whitney-U and Pearson χ2 correlation were used to compare LPN and RAPN. A matched pair comparison was also performed. Spearman correlation (Rho) was used to evaluate the relationship between clinical, intra and post-operative and pathological patients characteristics with MIC score. A binary regression analysis was also performed to evaluate independent factors associated with MIC success. Results: The MIC rate in LPN and RAPN was 55% and 65.5% respectively. No differences in clinical, intra and post-operative outcomes between groups were found. Clinical tumor size (p-value: < 0.001; OR: 0.829; 95% CI: 0.697-0.987), PADUA score (p-value: < 0.001; OR: 0.843; 95% CI: 0.740-0.960), PADUA risk groups (inter- mediate; p-value: < 0.001; OR: 0.416; 95% CI: 0.238- 0.792; high: p-value: < 0.001; OR: 0.356; 95% CI: 0.199- 0.636), WIT (p-value: < 0.001; OR: 0.598; 95% CI: 0.530- 0.675) were independently associated with MIC. eGFR (< 60 vs ≥ 60 ml/min per 1.73 m 2 : p-value: < 0.001; OR: 3.356; 95% CI: 1.701-6.621) and Fuhrman nuclear grade (p-value: 0.014; OR: 1.798; 95% CI:1.129-2.865) were also independently associated with MIC. Conclusions: MIC score system is a simple and useful tool to report and to compare different surgical approach. KEY WORDS: Complications; Laparoscopic partial nephrectomy; Positive margins; Robot-assisted partial nephrectomy; Warm ischemia time. Submitted 5 September 2014; Accepted 31 December 2014 Summary No conflict of interest declared. INTRODUCTION International guidelines on Renal Cell Carcinoma (RCC), states that renal tumors ≤ 7 cm are best managed by nephron sparing surgery (NSS) (1, 2). Open partial nephrectomy (OPN) represents the gold standard for renal tumors ≤ 7 cm, while laparoscopic partial nephrec- tomy (LPN) and Robot-Assisted Partial Nephrectomy (RAPN) are the main alternatives. Partial nephrectomy (PN) is a more complex procedure and several aspects must to be evaluated (3). In recent years PN become a challenge procedure to have less Warm Ischemia Time (WIT), which represent the most important predictor of renal function after PN (4). As reported by some Authors (5) the best PN should ideally be without ischemia, but, when required, it should not exceed 20 minutes for warm ischemia and < 35 minutes for cold ischemia. Ten years after the first case described by Gettman et al. (6), RAPN seems to be a promising procedure able to bridge the technical difficulties of LPN (7). RAPN has helped to reduce the surgical learning curve needed, and short- ened operative and ischaemic times with less blood loss compared with LPN. In 2012 Buffi et al. (8), proposed a new score system to evaluate success in PN, the Margin, Ischemia and Complications (MIC). According to this newly proposed scoring system, an optimal PN is accom- plished when surgical margins (SM) are negative, WIT was ≤ 20 minutes and no major complication (9) (Clavien-Dindo grade 3-4) were observed. The use of this simple system could be of paramount importance to compare and evaluate different approach used to per- form PN. Aim of this study is to evaluate difference between LPN and RAPN, from a single center experi- ence, using the MIC score and to evaluate pre, intra and post-operative factors that may potentially influence this scoring system. MATERIALS AND METHODS This is a retrospective single centre study approved by the local ethical committee. All patients were counselled about the risks, benefits and alternative treatments for DOI: 10.4081/aiua.2015.1.49