机器人外科学杂志（中英文）2023，Vol.4Issue(4)：333-342,10.DOI:10.12180/j.issn.2096-7721.2023.04.004
后腹膜机器人与腹腔镜肾肿瘤部分切除术:一项单一外科医生围手术期疗效的配对比较
Retroperitoneal robotic versus laparoscopic partial nephrectomy for renal tumors: a matched comparison of perioperative outcomes of a single surgeon
摘要
Abstract
Objective: To compare the perioperative outcomes of patients undergoing retroperitoneal laparoscopic partial nephrectomy(LPN) and retroperitoneal robot-assisted partial nephrectomy (RPN) by matched analysis using R.E.N.A.L. nephrometry scoring system. Methods: Relevant clinical data of 543 case of laparoscopic and robot-assisted partial nephrectomy performed by a single surgeon via the RP approach from January 2016 to March 2020 from our database were screened and analyzed. Two groups were matched 1:1 (112 matched pairs) by R.E.N.A.L. nephrometry score, gender, and age. Statistical analysis was done to compare perioperative outcomes. Results: There was no significant difference between the LPN group and RPN group in terms of age, gender, body mass index (BMI), tumor size, American Society of Anesthesiologists (ASA) score or preoperative estimated glomerular filtration rate (eGFR). Patients undergoing LPN had a slightly higher proportion of the left side tumor (51.7％ Vs 42.9％, P=0.032). No significant differences regarding to operative time, estimated blood loss, postoperative LOS, postoperative eGFR, transfusion or postoperative complications were found between the two groups. However, Warm ischemia times (WIT) in the RPN group were significantly shorter than that in the LPN group (18.9 min Vs 22.6 min, P=0.032). Subset analysis based on complexity indicated that WIT of complex tumors in the RPN group was significantly shorter than that in the LPN group (21.1 min Vs 26.3 min, P=0.012), but no difference of WIT was found on simple tumors between the RPN group and LPN group (16.4 min Vs 18.3 min, P=0.085). Conclusion: Retroperitoneal RPN showed shorter WIT and generally equivalent perioperative results to retroperitoneal LPN. Robotic surgery may have advantages over the traditional laparoscopic surgery on complex tumor excision and renorrhaphy in the limited retroperitoneal space.关键词
肾细胞癌/肾部分切除术/腹腔镜手术/机器人辅助手术Key words
Renal cell cancer/Partial nephrectomy/Laparoscopic surgery/Robot-assisted surgery分类
医药卫生引用本文复制引用
徐一帆,王平,夏丹,孟宏舟,秦杰,孔德波,景泰乐,叶孙益,来翀,汪朔..后腹膜机器人与腹腔镜肾肿瘤部分切除术:一项单一外科医生围手术期疗效的配对比较[J].机器人外科学杂志（中英文）,2023,4(4):333-342,10.基金项目
国家自然科学基金(81772270)National Natural Science Foundation(81772270) （81772270）
