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机器人辅助腹腔镜下肾血管平滑肌脂肪瘤的安全性和有效性比较:倾向评分匹配分析研究。

Comparisons of the Safety and Effectiveness of Robot-Assisted Laparoscopic Partial Nephrectomy for Central Renal Angiomyolipomas: A Propensity Score-Matched Analysis Study.

机构信息

Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, China.

Suzhou Kowloon Hospital, Shanghai Jiaotong University School of Medicine, Suzhou, China.

出版信息

J Endourol. 2023 Sep;37(9):1028-1036. doi: 10.1089/end.2023.0162. Epub 2023 Aug 14.

Abstract

To compare the safety and effectiveness of robot-assisted partial nephrectomy (RAPN) laparoscopic partial nephrectomy (LPN) in the treatment of central renal angiomyolipomas (AMLs). We retrospectively analyzed the clinical data of 103 patients who were treated with either RAPN or LPN for central AMLs between January 2017 and June 2022. Propensity scores were matched according to sex, age, laterality, body mass index, symptoms, diameter of tumor, location of tumor distribution, R.E.N.A.L score, preoperative hemoglobin, preoperative serum creatinine, preoperative estimated glomerular filtration rate, chronic disease, previous abdominal surgery, preoperative selective arterial embolization, American Society of Anesthesiologists scale, and duration of follow-up, and after matching, perioperative and prognostic data of the two groups were compared. A total of 57 patients underwent RAPN, and 46 patients underwent LPN. Before matching, there were more complex AMLs in the RAPN group, and R.E.N.A.L scores differed between the two groups (10 9,  < 0.001). After matching, the median warm ischemic time in the RAPN group was significantly shorter than that in the LPN group (21.5 minutes 28 minutes,  = 0.034), as well as the median time of postoperative mobilization (1 day 2 days,  < 0.001). The other indicators were not significantly different between the groups. For central AMLs, both RAPN and LPN were safe and feasible surgical treatments, but RAPN might be associated with shorter warm ischemia time and earlier postoperative mobilization.

摘要

比较机器人辅助部分肾切除术(RAPN)与腹腔镜部分肾切除术(LPN)治疗中央肾血管平滑肌脂肪瘤(AML)的安全性和有效性。我们回顾性分析了 2017 年 1 月至 2022 年 6 月期间接受 RAPN 或 LPN 治疗中央 AML 的 103 例患者的临床资料。根据性别、年龄、侧别、体重指数、症状、肿瘤直径、肿瘤分布位置、R.E.N.A.L 评分、术前血红蛋白、术前血清肌酐、术前估算肾小球滤过率、慢性疾病、既往腹部手术史、术前选择性动脉栓塞、美国麻醉医师协会评分以及随访时间进行倾向评分匹配,匹配后比较两组围手术期和预后数据。共 57 例行 RAPN,46 例行 LPN。匹配前,RAPN 组 AML 更复杂,两组 R.E.N.A.L 评分不同(10 9,  < 0.001)。匹配后,RAPN 组热缺血时间中位数明显短于 LPN 组(21.5 分钟 28 分钟,  = 0.034),术后下床活动时间中位数也明显短于 LPN 组(1 天 2 天,  < 0.001)。两组其他指标无显著差异。对于中央 AML,RAPN 和 LPN 均是安全可行的手术治疗方法,但 RAPN 可能与较短的热缺血时间和更早的术后下床活动相关。

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