Single-center Experience Of Robot-assisted Laparoscopic Nephron-sparing Surgery For Giant Renal Hamartoma

Objective:The application of robot-assisted laparoscopic nephron-sparing surgery in the treatment of patients with huge renal hamartoma(>7cm),and summarizes its surgical indications and skills.Methods:Included patients who underwent laparoscopic or robot-assisted laparoscopic nephron-sparing surgery in our center from October 2014 to January 2020,and the postoperative pathology was confirmed to be huge renal hamartoma,and retrospective analysis of the clinical experience of the included patients during their hospitalization Data and follow-up status.Results:A total of 40 patients underwent laparoscopic or robot-assisted laparoscopic nephron-sparing surgery and postoperative pathology was clear as giant renal hamartoma,they were successfully completed the operation.The clinical data of the robot group(Robot-assisted partial nephrectomy,RAPN)and the laparoscopic group(Laparoscopic partial nephrectomy,LPN)are as follows: There is no statistically significant difference in general data such as gender,age,body mass index,and tumor diameter between the two groups(P> 0.05).The operation time of RAPN group and LPN group were(179.17±34.17)min,(146.32±25.76)min,intraoperative blood loss was(116.67±61.55)ml,(192.14±47.52)ml,postoperative-preoperative blood creatinine The changes were(12.36±9.18)umol/L and(23.08±7.62)umol/L,and the total cost was(6.72±0.41)ten thousand yuan and(5.62±1.08)respectively.The difference was statistically significant(P<0.05).Postoperative pathology of the two groups of patients was confirmed to be renal angiomyolipoma;postoperative telephone follow-up(6-52)months,with an average follow-up of 20.5 months,there was no recurrence on the surgical side;postoperative complications of the two groups of patients,including laparoscopic One patient in the group had postoperative active bleeding,which improved after blood transfusion and embolization.Conclusion:This study shows that for patients with huge renal hamartoma,they receive robot-assisted laparoscopic nephron-sparing surgery,under the guidance of strict evaluation of robot laparoscopic surgery indications and mastery of surgical skills.Compared with conventional laparoscopy,robot-assisted laparoscopy can also achieve good tumor control and better protect renal function,but the total cost is higher.