Department of Urology, Ruijin Hospital, Shanghai Jiao Tong University Medical School, Shanghai, China.
J Invest Surg. 2021 Nov;34(11):1248-1253. doi: 10.1080/08941939.2020.1770377. Epub 2020 Jun 30.
To compare the perioperative outcomes between robotic posterior retroperitoneal adrenalectomy (RPRA) with laparoscopic posterior retroperitoneal adrenalectomy (LPRA) for adrenal tumors and to identify which group of patients may benefit from RPRA.
A total of 401 patients who fulfilled the inclusion criteria were collected and analyzed; among them, 86 and 315 patients underwent RPRA and LPRA, respectively. To adjust for potential baseline confounders, propensity score matching (PSM) was conducted at a 1:1 ratio. Patient demographics and perioperative outcomes were compared between the two groups.
After matching, no differences were found between the two groups in patient demographics or tumor characteristics. The median length of postoperative stay (3 vs. 4 days, = 0.001) was significantly shorter in the RPRA group, but this group also showed a higher median total hospitalization cost (8121.89 vs. 4107.92 $, < 0.001). There was no difference in the median operative duration (100 vs. 110 min, = 0.554), median estimated blood loss (50 vs. 50 ml, = 0.730), transfusion rate ( = 0.497) or incidence of postoperative complications ( = 0.428).
According to our research, RPRA leads to a shorter postoperative hospitalization stay but a higher total hospitalization cost than LPRA after propensity score matching.
比较机器人辅助后腹腔镜肾上腺切除术（RPRA）与腹腔镜后腹腔镜肾上腺切除术（LPRA）治疗肾上腺肿瘤的围手术期结果，并确定哪组患者可能从 RPRA 中获益。
共收集并分析了符合纳入标准的 401 例患者；其中 86 例和 315 例患者分别接受了 RPRA 和 LPRA。为了调整潜在的基线混杂因素，采用 1:1 比例进行倾向评分匹配（PSM）。比较两组患者的人口统计学和围手术期结果。
匹配后，两组患者的人口统计学和肿瘤特征无差异。RPRA 组术后住院时间中位数（3 天比 4 天， = 0.001）明显缩短，但该组总住院费用中位数也较高（8121.89 美元比 4107.92 美元， < 0.001）。手术时间中位数（100 分钟比 110 分钟， = 0.554）、估计出血量中位数（50 毫升比 50 毫升， = 0.730）、输血率（ = 0.497）和术后并发症发生率（ = 0.428）无差异。
根据我们的研究，在倾向评分匹配后，RPRA 导致术后住院时间缩短，但总住院费用高于 LPRA。
