Department of Urology, Gifu University Graduate School of Medicine, Gifu 5011194, Japan.
Department of Urology, Matsunami General Hospital, Gifu 5016062, Japan.
Medicina (Kaunas). 2022 Mar 27;58(4):485. doi: 10.3390/medicina58040485.
Background and objectives: This study aimed to evaluate the association between warm ischemic time (WIT) and postoperative renal function using Trifecta achievement in patients with renal cell carcinoma (RCC) who underwent robotic (RAPN) or laparoscopic partial nephrectomy (LPN). Materials and Methods: We conducted a retrospective multicenter cohort study of patients with RCC who underwent RAPN (RAPN group) or LPN (LPN group) at three institutions in Japan between March 2012 and October 2021. The primary endpoints were the rate of trifecta achievement in both surgical techniques and the association between WIT and recovery of postoperative renal function surgical outcomes. Results: The rate of trifecta achievement was significantly lower in patients with LPN than in those with RAPN (p < 0.001). WIT ≥ 25 min were 18 patients (18%) in the RAPN group and 89 (52.7%) in the LPN group. The postoperative estimated glomerular filtration rate (eGFR) was almost the same. However, 13 patients (7.7%) had a decreased in eGFR ≥ 15% at 3 months after LPN compared with the preoperative eGFR. Conclusions: The rate of trifecta achievement in the RAPN group was significantly higher than that in the LPN group. However, eGFR was identified as relatively better preserved after PN in both groups.
本研究旨在评估在接受机器人辅助肾部分切除术（RAPN）或腹腔镜肾部分切除术（LPN）的肾细胞癌（RCC）患者中，热缺血时间（WIT）与术后肾功能之间的关系。
我们对 2012 年 3 月至 2021 年 10 月在日本三家机构接受 RAPN（RAPN 组）或 LPN（LPN 组）的 RCC 患者进行了回顾性多中心队列研究。主要终点是两种手术技术的 trifecta 实现率以及 WIT 与术后肾功能恢复之间的关联。
LPN 组的 trifecta 实现率明显低于 RAPN 组（p < 0.001）。RAPN 组中 WIT≥25min 的患者有 18 例（18%），LPN 组中有 89 例（52.7%）。术后估算肾小球滤过率（eGFR）几乎相同。然而，与术前 eGFR 相比，LPN 术后 3 个月时，有 13 例（7.7%）的 eGFR 下降≥15%。
RAPN 组的 trifecta 实现率明显高于 LPN 组。然而，两组患者的 PN 后 eGFR 均被认为保存得相对较好。
