{
  "abstract": "BACKGROUND AND OBJECTIVE: The sutureless (SL) purely off-clamp robotic partial nephrectomy (ocRPN) technique has been proposed to minimize postoperative functional damage. We assessed whether this approach is noninferior to renorrhaphy (RR) in terms of surgical quality. METHODS: Patients with cT1-2N0M0 renal tumors were randomly assigned to SL or RR-ocRPN within a single-center, single-surgeon randomized controlled trial (NCT06846112). A covariate-adaptive 1:1 randomization algorithm ensured balance between treatment arms for age, sex, baseline renal function, and tumor surgical complexity. The primary endpoint was Trifecta achievement at discharge. A prespecified noninferiority test (margin -10%) compared Trifecta rates using one-sided testing and confidence intervals. Secondary outcomes were descriptively analyzed and compared between study arms. Recurrence-free survival (RFS) was estimated using the Kaplan-Meier method. KEY FINDINGS AND LIMITATIONS: Among 248 patients, baseline characteristics were balanced. Trifecta was achieved in 93% and 95% of cases (absolute difference -2.4%; 90% confidence interval [CI] -7.4%-2.6%), meeting the criterion for noninferiority (one-sided p = 0.006). Blood transfusions (2.4% vs 0%) and acute kidney injury (1.6% in both groups) were rare. Nine urinary fistulae occurred overall, all managed with temporary stenting; rates were higher in the SL group but not statistically significant (p = 0.08). Renal function remained stable up to 12 mo, and 1-yr RFS was 99% in all cohorts. Limitations include single-center design, surgeon expertise, and short oncologic follow-up. CONCLUSIONS AND CLINICAL IMPLICATIONS: SL-ocRPN is safe and effective and represents a feasible alternative to RR-ocRPN in selected cT1-2N0M0 renal tumors.",
  "abstract_shown": true,
  "affiliations": [
    "Uro-Oncology Program, IRCCS Regina Elena National Cancer Institute, Rome, Italy. Electronic address: aldo.brassetti@gmail.com",
    "Uro-Oncology Program, IRCCS Regina Elena National Cancer Institute, Rome, Italy",
    "Clinical Trial Center-Biostatistics & Bioinformatics, IRCCS Regina Elena National Cancer Institute, Rome, Italy"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 21,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Aldo Brassetti",
      "orcid": "0000-0001-9643-8979"
    },
    {
      "affs": [
        1
      ],
      "name": "Gabriele Tuderti",
      "orcid": "0000-0003-4480-9090"
    },
    {
      "affs": [
        1
      ],
      "name": "Umberto Anceschi",
      "orcid": "0000-0002-7586-4132"
    },
    {
      "affs": [
        1
      ],
      "name": "Alfredo Maria Bove",
      "orcid": "0000-0002-5139-9993"
    },
    {
      "affs": [
        1
      ],
      "name": "Eugenio Bologna",
      "orcid": "0000-0002-1140-0590"
    },
    {
      "affs": [
        1
      ],
      "name": "Lorenzo Capecchi",
      "orcid": "0009-0005-5929-8993"
    },
    {
      "affs": [
        1
      ],
      "name": "Giuseppe Chiacchio",
      "orcid": "0000-0002-8821-8201"
    },
    {
      "affs": [
        1
      ],
      "name": "Simone D’Annunzio",
      "orcid": "0000-0002-7495-614X"
    },
    {
      "affs": [
        1
      ],
      "name": "Mariaconsiglia C. Ferriero",
      "orcid": "0000-0001-5188-8001"
    },
    {
      "affs": [
        1
      ],
      "name": "Rocco Simone Flammia",
      "orcid": "0000-0002-3129-0544"
    },
    {
      "affs": [
        1
      ],
      "name": "Salvatore Guaglianone"
    },
    {
      "affs": [
        1
      ],
      "name": "Sabrina Iuculano"
    },
    {
      "affs": [
        1
      ],
      "name": "Claudia Denaro"
    },
    {
      "affs": [
        1
      ],
      "name": "Arianna Di Luzio"
    },
    {
      "affs": [
        1
      ],
      "name": "Costantino Leonardo"
    },
    {
      "affs": [
        1
      ],
      "name": "Leslie Claire Licari",
      "orcid": "0000-0002-3274-1247"
    },
    {
      "affs": [
        1
      ],
      "name": "Riccardo Mastroianni",
      "orcid": "0000-0003-3708-2209"
    },
    {
      "affs": [
        1
      ],
      "name": "Leonardo Misuraca",
      "orcid": "0000-0002-6521-6289"
    },
    {
      "affs": [
        1
      ],
      "name": "Flavia Proietti",
      "orcid": "0000-0002-6478-8584"
    },
    {
      "affs": [
        2
      ],
      "name": "Isabella Sperduti",
      "orcid": "0000-0001-5115-3099"
    },
    {
      "affs": [
        1
      ],
      "name": "Giuseppe Simone",
      "orcid": "0000-0002-4868-9025"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/9yxnpfv5z45xb.bib",
  "cited_by": 9,
  "doi": "10.1016/j.eururo.2026.04.019",
  "fulltext_url": null,
  "id": "9yxnpfv5z45xb",
  "issns": [
    "0302-2838",
    "1421-993X",
    "1873-7560"
  ],
  "landing_url": "https://doi.org/10.1016/j.eururo.2026.04.019",
  "language": "en",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2740|Renal cell carcinoma treatment"
    ]
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  "openalex": "W7161246402",
  "pdf_url": null,
  "pmcid": null,
  "pmid": "42135177",
  "published": "2026-05-15",
  "publisher": "Elsevier BV",
  "ris": "https://research.draconitic.com/paper/9yxnpfv5z45xb.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T13:26:56Z",
      "native_id": "W7161246402",
      "source": "openalex",
      "url": "https://doi.org/10.1016/j.eururo.2026.04.019"
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2740|Renal cell carcinoma treatment",
      "subfield": "general"
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  ],
  "title": "Sutureless Purely Off-clamp Robotic Partial Nephrectomy: Evidence from a Randomized Controlled Noninferiority Trial",
  "title_text": "Sutureless Purely Off-clamp Robotic Partial Nephrectomy: Evidence from a Randomized Controlled Noninferiority Trial",
  "type": "peer-reviewed",
  "updated_at": "2026-11-04T13:21:15Z",
  "url": "https://research.draconitic.com/paper/9yxnpfv5z45xb",
  "venue": "European Urology",
  "versions": []
}