Comparison Of Robot-assisted Laparoscopic Versus Conventional Laparoscopic Partial Nephrectomy For Renal Tumors With R.E.N.A.L.Score?7

ObjectivesTo evaluate the safety and efficacy of Robot-assisted Laparoscopic and Conventional Laparoscopic partial nephretomy in treating complex renal tumors with R.E.N.A.L.score?7.Subjects and MethodsA retrospective analysis was performed for 135 consecutive patients who underwent either RAPN(n=80)or LPN(n=55)by the same surgeon between Jan2013 and Dec 2017 for a complex renal mass(R.E.N.A.L.score?7).The age,gender,BMI,tumor size,R.E.N.A.L.score,ASA score,operative time,estimated blood loss,warm ischemia time,intraoperative complications,transfusion,postoperative complications,radical nephrectomy conversion,postoperative hospital stay,surgical margin were compared between the two groups..The date of the two groups were analyzed by SPSS19.0 statistical software package.According to different cases,t test and?~2 test were used to analyze the difference.The difference was statistically significant(P<0.05).To analysis the clinical safety and feasibility of Robot-assisted Laparoscopic and Laparoscopic partial nephretomy in treating complex renal tumors with R.E.N.A.L.score?7.ResultsThe operations were completed successfully in RAPN except for 4 case in LPN group that 2 case required conversion to radical nephrectomy and 2 case required conversion to open operation.The mean operative time of the two groups was(108.2±25.5 vs 130.0±30.7min,P<0.05),warm ischemia time was(19.8±2.3 vs22.1±2.5min,P<0.05),estimated blood loss(103.5±30.1ml vs 142.9±46.3ml,P<0.05)and postoperative complications(P<0.05).No significant differences were found in age,gender,BMI,tumor size,R.E.N.A.L.score,ASA score,intraoperative complications,transfusion,postoperative complications,radical nephrectomy conversion,post-operative hospital stay,surgical complications,surgical margin bloodand transfusion rate between the two groups(P>0.05).Postoperative pathology results revealed 94renal cell carcinoma,20 angiomyolipomas,5papillary renal cell carcinoma,7chromophobe renal cell carcinoma,5 spindle cell carcinoma,4 renal oncocytoma.The surgical margins were negative in both group.ConclusionAs a prerequisite,to ensure the same surgical effect for complicated renal tumors with R.E.N.A.L.score?7,the Robot-assisted Laparoscopic has the advantages of shorter operation time,warm ischemia time,estimated blood loss and postoperative complications makes the complicated renal partial resection a good safety and feasibility.The robot-assisted laparoscopic will be the main way to treat highly complex renal tumors in the future.