Comparative Analysis Of Clinical Effects Of Robot-assisted Zero-ischemic Partial Nephrectomy For Renal Parenchyma Suture And Suture-free Therapy For Renal Tumors

Object:To explore the safety,feasibility and clinical efficacy of robot-assisted zeroischemia suture-free partial nephrectomy for renal tumors.Methods:A retrospective analysis of 35 cases of renal tumors admitted to the Urology Department of the First Affiliated Hospital of Nanchang University from May 2017 to February 2020.All patients used zero-ischemic robot-assisted partial nephrectomy.Patients were divided into suture group and sutureless group according to whether the renal parenchyma was sutured.Two groups of demographic and perioperative data were collected,and creatinine and GFR were used to analyze and evaluate renal function before and 1 week and 3 months after surgery.Results:All patients successfully completed the operation,and there were no cases of transfer clamp or open,and no transfer suture cases in the suture-free group.There were no intraoperative and postoperative blood transfusion cases,and no complications above Clavien grade ? occurred.Compared with the suture group,the operation time of the suture-free group was shorter 70(50-135)min vs 123(75-165)min(P <0.001),The median rate of decline in renal GFR at 1 week after surgery was11%(1%-27%)vs 20%(12%-35%)(P = 0.010)and the median rate of decline in renal GFR at 3 months after surgery was 8%(-3%-25%)vs 19%(8%-32%)(P<0.001)was lower.All 35 patients had negative surgical margins.The median follow-up of the two groups was 7(3-11)months in the suture-free group and 28(10-35)months in the suture group.None of the patients had tumor recurrence.Conclusion:Robot-assisted zero-ischemia suture-free partial nephrectomy is a safe and feasible operation for the treatment of renal tumors with lower RENAL score.This operation shortens the operation time,avoids the impact of ischemia on renal function,and maximizes the preservation of healthy kidney,The short-term effect is definite.