Thomsen Frederik F, Petersson Rasmus D, Schou-Jensen Katrine S, Rashu Badal S, Niebuhr Malene H, Azawi Nessn H
Department of Urology, Copenhagen University Hospital, Herlev and Gentofte Hospital, Herlev, Denmark.
Department of Urology, Zealand University Hospital, Roskilde, Denmark.
Int Urol Nephrol. 2025 Jan 14. doi: 10.1007/s11255-025-04372-x.
To compare operative and oncological outcomes, as well as the risk of postoperative complications in patients who underwent transperitoneal robot-assisted partial nephrectomy (RAPN) for renal tumours located either posteriorly or anterolaterally.
Retrospective, consecutive study including 451 patients who underwent transperitoneal RAPN for non-metastatic, localised renal tumours from May 2016 to April 2023. Operative data included duration of the procedure, warm ischaemia time, and blood loss; oncological data included surgical margins and recurrence; and 90-day postoperative complications were classified according to the Clavien-Dindo classification.
In total, 140 (31%) patients had tumours with a posterior location. The median follow-up was 3.3 (IQR 1.8-5.0) years. There were no differences in operative outcomes or length of hospital stay between the two groups. Positive surgical margins were recorded in 9% of the patients with posterior tumours compared to 7% of patients with anterolateral tumours, p = 0.60. The estimated probability of recurrence-free survival at 5 years was 95.2% (95% CI 87.4-98.2) for patients with posterior tumours and 96.7% (95% CI 92.3-98.6) for patients with anterolateral tumours, p = 0.4. Patients with posterior tumours had a similar risk of any complication (OR 1.24 [95% CI 0.80-1.91]) and CD ≥ III (OR 0.73 [95% CI 0.28-1.67]) compared to patients with anterolateral tumours.
This study found that patients with posterior tumours had longer operating times and hospital stays following transperitoneal RAPN compared to those with anterolateral tumours but without increased complications or poorer oncological outcomes.
比较经腹腔机器人辅助部分肾切除术（RAPN）治疗位于后侧或前外侧肾肿瘤患者的手术及肿瘤学结局，以及术后并发症风险。
回顾性连续研究，纳入2016年5月至2023年4月期间因非转移性局限性肾肿瘤接受经腹腔RAPN的451例患者。手术数据包括手术时长、热缺血时间和失血量；肿瘤学数据包括手术切缘和复发情况；术后90天并发症根据Clavien-Dindo分类进行分级。
共有140例（31%）患者的肿瘤位于后侧。中位随访时间为3.3（四分位间距1.8 - 5.0）年。两组患者的手术结局或住院时间无差异。后侧肿瘤患者中9%出现手术切缘阳性，前外侧肿瘤患者中这一比例为7%，p = 0.60。后侧肿瘤患者5年无复发生存的估计概率为95.2%（95%置信区间87.4 - 98.2），前外侧肿瘤患者为96.7%（95%置信区间92.3 - 98.6），p = 0.4。与前外侧肿瘤患者相比，后侧肿瘤患者发生任何并发症的风险相似（比值比1.24 [95%置信区间0.80 - 1.91]），发生Clavien-Dindo分级≥III级并发症的风险也相似（比值比0.73 [95%置信区间0.28 - 1.67]）。
本研究发现，与前外侧肿瘤患者相比，经腹腔RAPN治疗后侧肿瘤的患者手术时间和住院时间更长，但并发症未增加，肿瘤学结局也未变差。
