Comparison Of Curative Effects For Complicated Renal Tumors Between Robot-Assisted Laparoscopic Partial Nephrectomy And Retroperitoneal Laparoscopic Partial Nephrectomy

Objective:A comparative analysis of the clinical efficacy of robot-assisted retroperitoneal partial nephrectomy and retroperitoneal laparoscopic partial nephrectomy with R.E.N.A.L score ?7 renal tumors.Method:To retrospectively analyze the clinical results of 29 patients who underwent robot-assisted retroperitoneal partial nephrectomy in our hospital from August 2015 to July 2017,and 61 patients undergoing retroperitoneal laparoscopic partial nephrectomy,Patients had complex renal tumors with an R.E.N.A.L score of ?7.Comparing the difference between the two groups in the average operation time,warm ischemia time,postoperative hospital stay,intraoperative blood loss,preoperative and postoperative serum creatinine ratio,perioperative complications,positive rate of margin,transit open rate,exhaust time and cost,etc.To analyze the safety and efficacy of RAPN in the treatment of renal tumor with RENAL score ?7.Results:A total of 90 patients were included in the two groups,of which only 1 case of large hamartoma(15*14*10cm)in the RLPN group was changed to open partial nephrectomy,and the rest were successfully completed.In RAPN group vsRLPN group,the operative time(159.3±60.7min vs.189.1±52.3min),warm ischemia time(23.5±5.5min vs.27.2±4.3min),and the increase of serum creatinine(21.9%±22.7%vs 38.2%±)There was a significant difference(20.5%)and total cost(58741.7±6840.4 yen vs 34114.3±4645.2 yen)(P<0.05).Transfusion rate(3.4% vs4.9%),complication rate(10.3% vs 8.2%),estimated blood loss(189.3±148.8 ml vs197.2±138.0 ml),positive margin(0 vs 0),postoperative There was no significant difference in the hospitalization time(7.5±2.1d vs 6.5±2.3d)and the venting time(1.5±1.0d vs 1.7±0.9d)(P>0.05).There was no tumor recurrence and metastasis inboth groups after a mean follow-up of 10 months.Conclusion:For complex renal tumors(RENAL score ?7),RAPN has shorter operative time,warm ischemia time,better preservation of renal function,and higher hospitalization costs compared with RLPN,estimating blood loss during surgery There were similarities in volume,perioperative complications,postoperative hospital stay,exhalation time,recurrence rate and survival rate at short-term follow-up.Overall,the short-term efficacy of RAPN in the treatment of complex renal tumors(R.E.N.A.L score ?7)is safe and reliable,and is superior to RLPN.Long-term efficacy needs further observation.