Rai Bhavan Prasad, Jones Patrick, Tait Campbell, Amitharaj Ramachandran, Gowda Raj, Bhatti Aftab, Adshead Jim, Somani Bhaskar
Department of Urology, James Cook University Hospital, Middlesbrough, United Kingdom.
Department of Urology, Royal Preston Hospital, Preston, United Kingdom.
Urology. 2018 Aug;118:6-11. doi: 10.1016/j.urology.2017.09.008. Epub 2017 Sep 28.
We systematically reviewed the world literature and compare oncological outcomes, morbidity, renal function, and perioperative outcome between cryotherapy and robotic-assisted partial nephrectomy (RAPN) for suspected renal malignancy. There was a statistically significant difference in "recurrence rates" between the 2 techniques, favoring the RAPN cohort. There was no statistically significant difference in overall and ≥Clavien 3a complication rates between the 2 techniques. The quality of evidence for recurrence rates, overall complication, and ≥Clavien 3a were "moderate", "low," and "very low," respectively, on GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. If a nephron sparing approach is indicated, RAPN should be the approach of choice.
我们系统地回顾了全球文献，并比较了冷冻疗法与机器人辅助部分肾切除术（RAPN）治疗疑似肾恶性肿瘤的肿瘤学结局、发病率、肾功能和围手术期结局。两种技术在“复发率”方面存在统计学显著差异，有利于RAPN队列。两种技术在总体并发症和≥Clavien 3a级并发症发生率方面无统计学显著差异。根据GRADE（推荐分级评估、制定和评价）方法，复发率、总体并发症和≥Clavien 3a级的证据质量分别为“中等”、“低”和“极低”。如果需要保留肾单位的方法，RAPN应是首选方法。
