Taniguchi Tomoki, Muraoka Kentaro, Nishikawa Kohei, Ikehata Yoshinori, Setoguchi Kiyoshi, Oka Suguru, Ebara Shin, Fujisaki Akira, Makiyama Kazuhide, Inoue Takahiro, Kitamura Hiroshi, Saito Kazutaka, Urakami Shinji, Yoneda Tatsuaki, Koie Takuya
Department of Urology, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan.
Department of Urology, Graduate School of Medicine, Yokohama City University, Yokohama, Japan.
Sci Rep. 2024 Dec 28;14(1):30986. doi: 10.1038/s41598-024-82197-x.
Renorrhaphy is often performed after tumor resection during robotic-assisted laparoscopic partial nephrectomy (RAPN). This study aimed to investigate the association between renorrhaphy performance and inflammatory markers. A retrospective cohort study was conducted including patients with renal cell carcinoma who underwent RAPN at eight institutions in Japan between April 2016 and November 2023. The primary endpoint was the association between the renorrhaphy performance in RAPN and the postoperative inflammatory markers. The secondary endpoints were perioperative outcomes in patients with and without renorrhaphy. The patients were divided into two groups at the time of RAPN: those who underwent renorrhaphy (renorrhaphy group) and those who did not (omitted group). In total, 934 patients were enrolled in this study. After propensity score matching, the rate of change in C-reactive protein and neutrophil-lymphocyte ratio on postoperative day 28 were not significant difference between the two groups. In contrast, the rate of change in platelet-lymphocyte ratio (PLR) on postoperative day 28 was significantly higher in renorrhaphy group than omitted group. Regarding surgical outcomes, the renorrhaphy group had a significantly longer hospital stay, operative time, and warm ischemia time (P = 0.038, P = 0.022, and P = 0.009, respectively) than the omitted group did. Furthermore, the omitted group had a significantly higher rate of Trifecta achievement than the renorrhaphy group did. This study demonstrated that renorrhaphy performance in RAPN was significantly associated with the higher value of postoperative PLR.
肾缝合术通常在机器人辅助腹腔镜部分肾切除术(RAPN)的肿瘤切除术后进行。本研究旨在探讨肾缝合术操作与炎症标志物之间的关联。进行了一项回顾性队列研究,纳入了2016年4月至2023年11月期间在日本八家机构接受RAPN的肾细胞癌患者。主要终点是RAPN中的肾缝合术操作与术后炎症标志物之间的关联。次要终点是接受和未接受肾缝合术患者的围手术期结局。在RAPN时将患者分为两组:接受肾缝合术的患者(肾缝合术组)和未接受肾缝合术的患者(省略组)。本研究共纳入934例患者。倾向得分匹配后,两组术后第28天C反应蛋白和中性粒细胞与淋巴细胞比值的变化率无显著差异。相比之下,肾缝合术组术后第28天血小板与淋巴细胞比值(PLR)的变化率显著高于省略组。关于手术结局,肾缝合术组的住院时间、手术时间和热缺血时间均显著长于省略组(P分别为0.038、0.022和0.009)。此外,省略组的三连胜达成率显著高于肾缝合术组。本研究表明,RAPN中的肾缝合术操作与术后较高的PLR值显著相关。