Clinical Application Of Robot-Assisted Partial Nephrectomy For Surgical Treatment In Renal Tumors

Object:The present study aimed to compare and analyze the efficacy and safety of Robot-Assisted Laparoscopic Partial Nephrectomy(RAPN)and Laparoscopic Partial Nephrectomy(LPN)for surgical treatment in renal tumors.To further explore the superiority of either surgical approach to the other in treatment,which would provide a reference for clinical option.Methods:A retrospective observational study was conducted with data prospectively collected from January 2018 to December 2020 in Urology department of China-Japan Union Hospital of Jilin University.The cohort was divided into two groups according to different surgical approaches,namely RAPN(n=12)and LPN(n=22).Thirty-four patients were managed by a transabdominal approach without bypass maneuvers.We assessed clinical benefits of the two groups through statistical analysis of clinical characteristics including gender,age,body mass index(BMI),tumor size,tumor side,R.E.N.A.L.score,preoperative glomerular filtration rate of the affected kidney(e GFR),operating time,warm ischemia time,estimated blood loss,rate of conversion to open surgery,postoperative glomerular filtration rate of the affected kidney(e GFR~1),decline rate in e GFR(△e GFR),rate of postoperative complications,drainage tube time,postoperative hospital stay.A P value less than 0.05was considered statistically significant.Results:The procedures were completed successfully in all cases.There were no statistically significant differences between the groups with respect to gender,age,BIM,tumor size,tumor side,R.E.N.A.L.score,e GFR,operating time,rate of conversion to open surgery,rate of postoperative complications,postoperative hospital stay(P>0.05).The statistically significant differences were found in warm ischemia time,estimated blood loss,e GFR~1,△e GFR,drainage tube time between the 2 groups(P<0.05).The postoperative pathology report showed a clear-cell renal-cell carcinoma in 29 cases,an angiomyolipoma in 2 cases,a papillary renal cell carcinoma in 2 cases,and a renal oncocytoma in another case.After surgical treatments,negative surgical margins were obtained in both groups.Conclusion:Under the prerequisite of obtaining the same surgical effect,Robot-Assisted Laparoscopic Partial Nephrectomy can decrease warm ischemia time,protect renal function,control Estimated blood loss,shorten drainage tube time.However,RAPN seems to offer on advantages in terms of operating time,rate of conversion to open surgery,rate of postoperative complications and postoperative hospital stay.It has demonstrated the safety and feasibility of Robot-Assisted Laparoscopic Partial Nephrectomy,which is thus expected to become the approach of first choice in managing renal tumors.