Haberal Hakan Bahadir, Artykov Meylis, Gudeloglu Ahmet, Yazici Sertac, Bilen Cenk Yucel
Department of Urology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Sisli Etfal Hastan Tip Bul. 2021 Jul 2;55(2):167-172. doi: 10.14744/SEMB.2020.33230. eCollection 2021.
The objectives of the study were to compare the operative features, complication rates, functional, and pathological outcomes of laparoscopic partial nephrectomy (LPN) and robotic-assisted partial nephrectomy (RPN).
The demographics, perioperative, and follow-up data of patients who underwent partial nephrectomy between January 2007 and April 2020 with minimally invasive methods were retrospectively analyzed. Patients with minimum 3 months follow-up were enrolled in the present study. Perioperative and pathological outcomes were compared between the patients underwent LPN and RPN.
A total of 85 patients (65 LPN and 20 RPN) were included in the present study. The mean patient age at the time of surgery was 56.31±10.48 years. Female-to-male ratio was 30/55. Patients in the RPN group had higher R.E.N.A.L. and PADUA scores (p=0.039 and p=0.030, respectively). Median warm ischemia time, median operation time, median intraoperative estimated blood loss, mean post-operative hemoglobin change, and median hospitalization time were similar between groups (p=0.133, p=0.753, p=0.079, p=0.882, and p=0.473, respectively). Artery-only clamping rate was significantly higher in RPN group (p=0.033). The cost of RPN was significantly greater than LPN (p<0.001). Transfusion rates, post-operative complication rates, percent of estimated glomerular filtration rate change at the last follow-up, and trifecta achievement were similar between the groups (p=0.622, p=0.238, p=0.428, and p=0.349, respectively).
In this series, similar perioperative and functional outcomes were achieved by RPN compared to LPN in more complex renal masses.
本研究的目的是比较腹腔镜部分肾切除术（LPN）和机器人辅助部分肾切除术（RPN）的手术特点、并发症发生率、功能及病理结果。
回顾性分析2007年1月至2020年4月间采用微创方法行部分肾切除术患者的人口统计学、围手术期及随访数据。本研究纳入了随访至少3个月的患者。比较接受LPN和RPN患者的围手术期及病理结果。
本研究共纳入85例患者（65例行LPN，20例行RPN）。手术时患者的平均年龄为56.31±10.48岁。男女比例为30/55。RPN组患者的R.E.N.A.L.和PADUA评分更高（分别为p=0.039和p=0.030）。两组间的中位热缺血时间、中位手术时间、中位术中估计失血量、术后血红蛋白平均变化及中位住院时间相似（分别为p=0.133、p=0.753、p=0.079、p=0.882和p=0.473）。RPN组的单纯动脉夹闭率显著更高（p=0.033）。RPN的费用显著高于LPN（p<0.001）。两组间的输血率、术后并发症发生率、最后一次随访时估计肾小球滤过率变化百分比及三联成功指标相似（分别为p=0.622、p=0.238、p=0.428和p=0.349）。
在本系列研究中，对于更复杂的肾肿块，RPN与LPN相比取得了相似的围手术期和功能结果。
