空军军医大学学报2025，Vol.46Issue(9)：1153-1157,1162,6.DOI:10.13276/j.issn.2097-1656.2025.09.006
机器人及腹腔镜与开放肾部分切除术治疗T1b期肾肿瘤术后肾功能的对比研究
Comparative study on postoperative renal function among robot-assisted,laparoscopic,and open partial nephrectomy for T1b renal tumors
摘要
Abstract
Objective To explore the differences in postoperative renal function among robot-assisted,laparoscopic,and open partial nephrectomy(PN)for T1b renal tumors.Methods A retrospective analysis was conducted on clinical data from 246 patients with T1b renal tumors who underwent PN at Xijing Hospital,Air Force Medical University from March 2009 to April 2023.The patients were divided into three groups:open partial nephrectomy(OPN)group(n=98),laparoscopic partial nephrectomy(LPN)group(n=102),and robot-assisted partial nephrectomy(RAPN)group(n=46).The estimated glomerular filtration rate(eGFR)and eGFR decline were compared among the three groups at 3 months,6 months,1 year,2 years,3 years,4 years,and 5 years postoperatively.Results The median follow-up duration was 12(6,48)months.Preoperative eGFR was higher in the LPN group compared to the OPN group(P=0.002)and higher in the RAPN group compared to the OPN group(P＜0.001),with no significant difference between LPN group and RAPN group(P=0.211).During follow-up,statistically significant differences in eGFR were observed among the groups at 3 months and 6 months postoperatively(P＜0.05),but no significant differences were found at 1-5 years postoperatively(P＞0.05).Pairwise comparisons at 3 months postoperatively showed higher eGFR in the LPN group(P=0.002)and RAPN group(P＜0.001)compared to the OPN group,with no significant difference between LPN group and RAPN group(P=0.108).At 6 months postoperatively,eGFR remained higher in the LPN group(P=0.010)and RAPN group(P=0.033)compared to the OPN group,with no significant difference between LPN group and RAPN group(P=0.940).For eGFR decline,significant differences were observed among the groups at 3 months postoperatively(P=0.044),but no significant differences were found at 6 months and 1-5 years postoperatively(P＞0.05).Pairwise comparisons at 3 months postoperatively showed greater eGFR decline in the OPN group compared to the LPN group(P=0.016),but no significant differences were observed between OPN group and RAPN group(P=0.102)or between LPN group and RAPN group(P=0.609).Conclusion The OPN group has worse baseline eGFR and greater eGFR decline at 3 months postoperatively,suggesting that minimally invasive techniques offer better early renal function preservation compared to traditional OPN.The long-term eGFR at 1-5 years postoperatively is similar among the three surgical procedures.Taking into account the preoperative baseline differences,it suggests that OPN may have a stronger protective effect on long-term renal function after surgery for T1b renal tumors.关键词
腹腔镜手术/机器人手术/开放手术/肾部分切除术/肾功能/肾肿瘤/微创外科手术/外科器械Key words
laparoscopic surgery/robotic surgery/open surgery/partial nephrectomy/renal function/renal tumor/minimally invasive surgical procedures/surgical instruments分类
医药卫生引用本文复制引用
李璇,陈美红,袁建林,郑万祥,鞠东恩,黄陆光,刘克普,魏迪,敦鑫龙,朱政,杨可勋..机器人及腹腔镜与开放肾部分切除术治疗T1b期肾肿瘤术后肾功能的对比研究[J].空军军医大学学报,2025,46(9):1153-1157,1162,6.基金项目
国家自然科学基金(61971425) （61971425）
陕西省自然科学基础研究计划项目(2024JC-YBQN-0984) （2024JC-YBQN-0984）
