| Purpose: To analyze and compare the clinical efficacy and safety between robot-assisted partial nephrectomy(RAPN)and laparoscopic partial nephrectomy(LPN)in the treatment of renal tumor patients.Methods: The clinical data of 85 patients with renal tumor treated by RAPN or LPN in the department of urology of our hospital from April 20,2020 to January 20,2021 were analyzed retrospectively.There were 44 patients in RAPN group(28 males and 16 females).The median diameter of the tumor was 3.0(2.2-4.2)cm,the median R.E.N.A.L.score was 8.0(7.0-9.0)and PADUA score was 6.0(5.3-8.0).LPN group(n = 41,male 26,female 15).The tumor median diameter was 2.9(2.4-3.8)cm,R.E.N.A.L.score was 8.0(7.0-9.0)and PADUA score was 7.0(6.0-8.0).The preoperative basic data and postoperative tumor results of the two groups were analyzed and compared.The operation time,estimated blood loss,intraoperative blood transfusion rate,renal warm ischemia time,operation conversion rate(to radical operation /open),incidence of postoperative complications,positive rate of incisal margin and postoperative hospital stay were recorded and compared between the two groups.Collate and summarize the clinical data,use Excel software for data entry,import SPSS24.0 software to establish database and analyze.The quantitative data satisfying normal distribution were statistically described by mean ±standard deviation,and two independent sample t-tests were used for comparison between the two groups,which were not satisfied with the median and quartile spacing of normal distribution,and rank sum test was used for comparison between the two groups.The number of cases and constituent ratio of quantitative data were described,and chi-square test and Fisher exact probability method were used for comparison between the two groups.The difference was statistically significant(P<0.05).Results: A total of 85 patients with renal tumors were included,including44 patients with robot-assisted partial nephrectomy and 41 patients with laparoscopic-assisted partial nephrectomy.The results of univariate analysis showed that there was no significant differencethe between two groups in terms of age,sex,tumor size,R.E.N.A.L.score and PADUA score.There were significant differences in operation time(108.23 ± 32.12 min vs 124.15 ±40.22min)and warm ischemia time 16(15-20)min vs 20(15-25)min(P< 0.05)between RAPN and LPN in the treatment of renal tumors.The results suggest that the operation time and warm ischemia time are shorter in patients with RAPN.There was no significant difference between the two surgical methods in postoperative hospital stay,blood transfusion rate,incidence of postoperative complications,positive rate of incisal margin and pathological types of tumor.Conclusion: For patients with renal tumor,although the two surgical methods are generally safe and effective,there is no significant difference in hospital stay,clinical blood transfusion rate,postoperative complications and positive rate of incisal margin.However,RAPN has more advantages than LPN in the time of operation and warm ischemia of kidney during operation.The robot’s high-definition three-dimensional field of vision and flexible manipulator have great advantages in partial nephrectomy,especially in the suture operation of the kidney,which shortens the time of warm ischemia and retains more renal function.Therefore,in the center where Da Vinci robot-assisted surgery can be carried out,RAPN can be considered as the first choice for such patients,especially for patients with complex renal tumors with absolute indications for nephron sparing surgery(NSS).Due to the small number of cases included in this study and the lack of long-term follow-up of patients,these biases may affect some of the results of the study.Therefore,we need more prospective,multicenter,large sample,long-term randomized controlled trials to further verify the advantages and disadvantages of the two surgical methods and the long-term results of oncology and renal function changes. |
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