Surgical and Oncologic Outcomes of Minimally Invasive Partial Nephrectomy Performed in 16 Centers of Hispanic-America.

e15626 Background: There is scant information on results of minimally invasive partial nephrectomy (PN) in Hispanic-America (HA). Our objective was to describe the perioperative and oncology outcomes in a series of laparoscopic or robotic PNs performed in 16 centers of HA from 1/1992-8/2014. Methods: Clinical, surgical and outcome information was collected. Kaplan Meier curves, logistic and Cox regression analyses explored variables associated with complications and recurrence. Clavien classification tabulated complications. Results: We evaluated 1034 laparoscopic or robotic PNs. Median age: 58 years, with a 2:1 male:female ratio. 97% were purely laparoscopic and 83% by a transperitoneal approach. Median surgical time: 150 minutes, with warm ischemia time of 20 minutes and intraoperative bleeding of 150cc. 80% of the lesions were malignant, with clear cell histology being 62.4% of the total. The median maximum tumor diameter was 2.8 cm. with a positive margins rate of 7.5%. Median hospitalization: 3 days. 21% patients had at least one complication; Clavien 1: 5%; Clavien 2: 10%; Clavien 3A: 1.43%; Clavien 3B: 3.8%; Clavien 4A: 0.82%; Clavien 4B: 0.2% and Clavien 5: 0%. Bleeding and urinary fistula were the main causes of re operation. Transfusion rate: 13%. Bleeding was the main cause of conversion to radical nephrectomy (1.5%) and conversion to open partial nephrectomy (2.8%). In multivariate analysis, maximum tumor diameter, (p: 0. 011) and the presence of two or more tumors in the same renal unit (p < 0.001) were significantly associated with greater likelihood of complications.19 patients had disease recurrence and or progression in a median follow-up of 22.8 months. The local or distant 5-year progression free rate was 93%. The corresponding cancer specific and overall survival was 99% and 98%, respectively.Females (p:0.005), bilateral tumors (p:0.004), need for reoperation (p:0.003) and positive margin (p:0,003) were significantly associated with a greater likelihood of disease recurrence and or progression. Conclusions: Laparoscopic PN with or without robotic assistance in these centers of Hispanic America is feasible with reasonable perioperative and oncologic outcomes.