Ann Ital Chir. 2020;91:321-326.
To evaluate renal function after laparoscopic nephron-sparing surgery (NSS) and to establish the factors that might influence its dynamic one year after surgery.
The prospective study included 83 patients previously diagnosed with renal cell carcinoma who underwent laparoscopic NSS. Demographic, clinical, laboratory and surgery related data were recorded. Patients were followed up for one year after surgery.
The majority of cases (63 (76.8%)) were included in stage T1a. Almost two thirds of patients underwent partial nephrectomy (PN) (54 (65.1%)). A slight decrease in GFR was observed 1 year after surgery (80.1±21.5 ml/min; 75.3±22.4 ml/min respectively) in all patients. Univariate analysis showed a significant decrease in GFR values one year after surgery for patients who underwent standard PN as compared with those from the enucleation group (p=0.003). Male patients showed a significant decrease in GFR one year after surgery, as compared with female patients (p<0.001), and elderly patients were more likely to show lower GFR. When considering the simultaneous influence of age, gender and type of surgery on the evolution of GFR, the threshold for statistical significance was slightly crossed (p=0.2).
Partial nephrectomy as compared to enucleation, advanced age and male gender are associated with impaired renal function at one year after laparoscopic NSS.
Enucleation, Laparoscopic partial nephrectomy, Renal cell carcinoma.
评估腹腔镜肾部分切除术（NSS）后的肾功能，并确定术后 1 年内影响其动态变化的因素。
这项前瞻性研究纳入了 83 例先前诊断为肾细胞癌并接受腹腔镜 NSS 的患者。记录了患者的人口统计学、临床、实验室和手术相关数据。对患者进行了 1 年的随访。
大多数病例（63 例（76.8%））为 T1a 期。将近三分之二的患者接受了部分肾切除术（PN）（54 例（65.1%））。所有患者术后 1 年肾小球滤过率（GFR）略有下降（80.1±21.5ml/min；75.3±22.4ml/min）。单因素分析显示，与剜除组相比，标准 PN 组术后 1 年 GFR 值显著下降（p=0.003）。与女性患者相比，男性患者术后 1 年 GFR 显著下降（p<0.001），老年患者 GFR 更可能下降。当同时考虑年龄、性别和手术类型对 GFR 演变的影响时，统计显著性的阈值略有超出（p=0.2）。
与剜除术相比，PN 术、高龄和男性与腹腔镜 NSS 后 1 年肾功能受损有关。
剜除术；腹腔镜部分肾切除术；肾细胞癌。
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