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经腹腔与腹膜后机器人辅助部分肾切除术效果的比较

Comparison of the effects of transperitoneal and retroperitoneal robot-assisted partial nephrectomy.

作者信息

Tao Meiman, Cheng Kang, Xu Wei, Qian Zhounan, Pan Peng

机构信息

Meiman Tao, Department of Urology, Affiliated Hospital of Jiangsu University, Zhenjiang City, Jiangsu Province, 212001, China.

Kang Cheng, Department of Urology, Affiliated Hospital of Jiangsu University, Zhenjiang City, Jiangsu Province, 212001, China.

出版信息

Pak J Med Sci. 2024 Nov;40(10):2202-2207. doi: 10.12669/pjms.40.10.10613.

DOI:10.12669/pjms.40.10.10613
PMID:39554681
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11568722/
Abstract

OBJECTIVE

To compare the effects of transperitoneal and retroperitoneal approaches for robotic assisted partial nephrectomy (RAPN) in patients with renal cell carcinoma (RCC).

METHODS

We conducted a retrospective cohort study on RAPN at Affiliated Hospital of Jiangsu University. Between September 2020 and February 2024, the included patients underwent either transperitoneal approach or retroperitoneal approach. Perioperative status, stress response, quality of life, and incidence of complications were compared between the groups.

RESULTS

A total of 105 patients were included in this analysis, with 54 patients in the Retroperitoneal group, and 51 patients in the Transperitoneal group. The retroperitoneal approach was associated with significantly better perioperative indicators compared to the transperitoneal method (<0.05). After the surgery, serum levels of interleukin-6 (IL-6), C-reactive protein (CRP), white blood cell count (WBC), and cortisol (Cor) in the Retroperitoneal group were lower than in the Transperitoneal group (<0.05). The quality-of-life scores of patients in the Retroperitoneal group were higher (<0.05), but no statistically significant difference in the incidence of complications between the groups (>0.05).

CONCLUSIONS

Compared with the transperitoneal approach, the retroperitoneal method of RAPN is equally safe and is associated with improved perioperative status, lower stress response, and better quality of life for RCC patients.

摘要

目的

比较经腹腔途径与经腹膜后途径行机器人辅助肾部分切除术(RAPN)治疗肾细胞癌(RCC)患者的效果。

方法

我们在江苏大学附属医院对RAPN进行了一项回顾性队列研究。2020年9月至2024年2月期间,纳入的患者接受了经腹腔途径或经腹膜后途径手术。比较两组患者的围手术期状况、应激反应、生活质量和并发症发生率。

结果

本分析共纳入105例患者,其中腹膜后组54例,经腹腔组51例。与经腹腔途径相比,经腹膜后途径的围手术期指标明显更好(<0.05)。术后,腹膜后组患者的血清白细胞介素-6(IL-6)、C反应蛋白(CRP)、白细胞计数(WBC)和皮质醇(Cor)水平低于经腹腔组(<0.05)。腹膜后组患者的生活质量评分更高(<0.05),但两组间并发症发生率无统计学差异(>0.05)。

结论

与经腹腔途径相比,经腹膜后途径的RAPN同样安全,且与改善RCC患者的围手术期状况、降低应激反应和提高生活质量相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c0f6/11568722/508b6e58af19/PJMS-40-2202-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c0f6/11568722/29f5d125aa97/PJMS-40-2202-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c0f6/11568722/e9df833eee44/PJMS-40-2202-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c0f6/11568722/a7a8e92b763e/PJMS-40-2202-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c0f6/11568722/508b6e58af19/PJMS-40-2202-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c0f6/11568722/29f5d125aa97/PJMS-40-2202-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c0f6/11568722/e9df833eee44/PJMS-40-2202-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c0f6/11568722/a7a8e92b763e/PJMS-40-2202-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c0f6/11568722/508b6e58af19/PJMS-40-2202-g004.jpg

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本文引用的文献

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Ann Oncol. 2024 Aug;35(8):692-706. doi: 10.1016/j.annonc.2024.05.537. Epub 2024 May 22.
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Comparison of the perioperative outcomes of robot-assisted laparoscopic transperitoneal versus retraperitoneal partial nephrectomy for posterior-lateral renal tumors: a systematic review and meta-analysis.机器人辅助腹腔镜经腹腔与后腹腔途径治疗后外侧肾肿瘤的围手术期结局比较:系统评价和荟萃分析。
J Robot Surg. 2024 Apr 29;18(1):186. doi: 10.1007/s11701-024-01963-1.
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经腹腔与经腹膜后机器人辅助部分肾切除术:系统评价和荟萃分析。
World J Urol. 2024 Feb 15;42(1):83. doi: 10.1007/s00345-024-04796-7.
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Robotic transperitoneal versus retroperitoneal approach for anterior renal mass nephron-sparing surgery.机器人经腹腔与经腹膜后途径行前位肾脏肿瘤保留肾单位手术。
J Robot Surg. 2024 Feb 14;18(1):75. doi: 10.1007/s11701-023-01798-2.
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