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基于术后早期估算肾小球滤过率(eGFR)的微创部分肾切除术(MIPN)的最佳手术效果。

Optimal Surgical Outcome of Minimally Invasive Partial Nephrectomy (MIPN) Based on an Early Postoperative Estimated Glomerular Filtration Rate (eGFR).

机构信息

Department of Urology, L'Institut Mutualiste Montsouris, Paris, France.

Department of Urology, Faculdade de Medicina do ABC, Santo Andre, Brazil.

出版信息

Curr Urol Rep. 2021 May 25;22(7):36. doi: 10.1007/s11934-021-01053-x.

Abstract

PURPOSE OF REVIEW

To compare laparoscopic partial nephrectomy (LPN) and robot-assisted partial nephrectomy (RAPN) performed in two European tertiary centers using the classic optimal surgical definition - "MIC" - and a new optimal surgical definition: the "Novel TRIFECTA" (NT) concept. We sought to strengthen the PN evidence and to test the NT's performance.

RECENT FINDINGS

The study population comprehended 505 cases of localized kidney cancer from two tertiary centers between 2012 and 2019. The NT achievement was higher in the RAPN group when compared to LPN (70.5 vs. 87.4%; p = 0.004), while no differences were found when considering the MIC criteria. Also, a similar high-grade complications rate (Clavien-Dindo > III) and operative time (105 min vs. 100 min; p = NS) were found. In the multivariable regression, the RAPN approach was a predictor of NT achievement (OR 2.45; p = 0.008). NT achievement was higher in the RAPN group, while similar results were found when evaluating the MIC criteria. The NT definition could be more sensitive to the individual-specific responses related to the PN.

摘要

目的综述

比较在两个欧洲三级中心使用经典的最佳手术定义(“MIC”)和新的最佳手术定义(“新三联征”[NT])进行腹腔镜部分肾切除术(LPN)和机器人辅助部分肾切除术(RAPN)。我们旨在加强 PN 的证据,并测试 NT 的性能。

最新发现

该研究人群包括 2012 年至 2019 年间两个三级中心的 505 例局限性肾癌患者。与 LPN 相比,RAPN 组的 NT 实现率更高(70.5%对 87.4%;p=0.004),而在考虑 MIC 标准时则没有差异。此外,还发现了类似的高分级并发症发生率(Clavien-Dindo > III)和手术时间(105 分钟对 100 分钟;p=NS)。在多变量回归中,RAPN 方法是 NT 实现的预测因素(OR 2.45;p=0.008)。RAPN 组 NT 实现率较高,而在评估 MIC 标准时则发现相似的结果。NT 定义可能对与 PN 相关的个体特异性反应更敏感。

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