Banti and colleagues hereby report a relevant and interesting study on a usually overlooked aspect of robot-assisted laparoscopic partial nephrectomy, the cost implications (and potential cost savings) of routine preoperative blood typing and crossmatching. In this single-center, retrospective cohort study of 804 patients undergoing robotic partial nephrectomy, the authors found that only 9 patients (1.1) required a transfusion, with a maximum of 2 blood units needed. The authors identified a significant difference in R.E.N.A.L. (for radius, exophytic/endophytic, nearness of tumor to collecting system, anterior/posterior, location relative to polar line) nephrometry score and operative blood loss between the transfused and nontransfused groups. These findings are both intuitive and interesting, as complex tumors are more likely to require difficult dissection techniques and advanced reconstructions, usually the situations in which bleeding occurs. In this series, almost all patients had stage pT1 tumors and vascular control was mostly artery-only clamping, which is the usual technique done in most centers.
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