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Clinical Efficacy Analysis Of Laparoscopic Partial Nephrectomy For Complex Renal Tumors With PADUA Scores≥10

Posted on:2024-08-03Degree:MasterType:Thesis
Country:ChinaCandidate:C GuoFull Text:PDF
GTID:2544306926477324Subject:Surgery
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Objective:Laparoscopic partial nephrectomy(LPN)for patients with complex renal tumors with a PADUA score≥10 is tough in tumor excision and kidney reconstruction,and may have a higher risk of perioperative complications.The effectiveness and safety have not yet been established.Our study is to compare the clinical effectiveness of laparoscopic partial nephrectomy versus laparoscopic radical nephrectomy(LRN)in the treatment of complicated renal tumors with a PADUA score≥10.Method:We reviewed the clinical data of 73 patients who received LRN or LRN for the PADUA score≥10 complex renal tumor from February 2020 to October 2022 in our center.The demographical characteristics,preoperative indicators,intraoperative and postoperative results were compared,multivariate logistic regression analyses explored the predictors of surgical complications and renal function.Results:40 patients performed LPN successfully,33 underwent LRN.There was no significant difference between the two groups at baseline characteristics.The estimated glomerular filtration rate(eGFR)at 1 day and 3 months after surgery was better in the LPN group than LRN group,and the number of patients with a decrease in eGFR≥25%was also less than that in the LRN group.Although the incidence of postoperative problems was higher in the LPN group than the LRN group(P=0.028),both were Clavien-Dindo grade 1 or 2 issues with no life-threatening consequences.In addition,the estimated blood loss during LPN operation(215.30 ≥ 200.46 ml)and the median time of drainage tube removal after operation 4(2)days were greater than those in LRN group(131.82±120.88 ml)and 3(1)days,with the difference being statistically significant.Male gender and higher preoperative creatinine may be an independent risk factor for complications after LPN,and higher age and preoperative eGFR may increase the risk of postoperative renal function loss.Conclusion:Under skilled conditions,LPN is a safe and effective choice for patients with complex renal tumors with PADUA score≥10.It has better renal function protection than LRN,but it may be accompanied by higher intraoperative bleeding,low-level postoperative complications risk and longer postoperative drainage tube retention time.
Keywords/Search Tags:Complex renal tumor, PADUA scores, Laparoscope, Nephrectomy
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