Comparison Of Efficacy Between RLPN And RLRN And Application Of R.E.N.A.L.Score In RLPN

Objective:By comparing the advantages and disadvantages of retroperitoneal laparoscopic partial nephrectomy and retroperitoneal radical nephrectomy in the treatment of localized renal cell carcinoma,the safety and feasibility of the two methods were compared;To explore the clinical application value of R.E.N.A.L.renal tumor system score in RLPN;To maximize the preservation of renal function for patients with localized renal carcinoma.Method:Retrospective analysis was performed on 85 cases of LRCC patients admitted to the Second Affiliated Hospital of Kunming Medical University from December 2018 to December 2020.Preoperative examinations of urinary system B ultrasound,CT,kidney scan and other examinations were completed,and postoperative pathological examination results were all renal tumors.According to the operation methods,the patients were divided into RLPN group and RLRN group;The RLPN group was divided into low and medium groups based on R.E.N.A.L.scores.The general case data.surgical data and R.E.N.A.L.tumor system score data were compared respectively,followed up for 6 months.Result:There was no significant difference between RLPN and RLRN in age,sex,lesion side,ASA score,BMI value,pathological type and other general medical records.There were significant differences in the reasons of treatment and PTNM stage(P<0.05).The operation time of RLPN group was significantly longer than that of RLRN group(P<0.05),and the difference was statistically significant.There were significant differences in postoperative GFR,postoperative total GFR,decreased rate of GFR and total GFR between the two groups(P<0.05).There were significant differences between the two groups in tumor diameter,exudation rate,distance from the collecting system,and percentage of tumor volume in upper/lower pole of kidney(P<0.05).The decrease rate of GFR in RLPN group was correlated with R.E.N.A.L.score(P<0.05),which was statistically significant;The R.E.N.A.L.scoring system showed significant differences in the amount of intraoperative blood loss,Warm ischemia time(WIT)and operative duration between the low group and the middle group(P<0.05).Conclusions:1.RLRN and RLPN are equally safe and effective in the treatment of localized R.E.N.A.L.cancer,but R.E.N.A.L.Patients with lower R.E.N.A.L.cancer scores were more likely to choose RLPN.2.Compared with RLRN,RLPN has the advantage of preserving R.E.N.A.L.function,but the operative time is longer than RLRN.In addition,there is no difference in intraoperative blood loss,hospital stay,intraoperative and postoperative complications,etc.3.The rate of GFR decline was associated with R.E.N.A.L.score.Preoperative R.E.N.A.L.system score can quantify the anatomical complexity of R.E.N.A.L.tumors and evaluate the difficulty of surgery,help patients answer related questions such as renal function impairment,and facilitate the effective communication between doctors and patients before surgery as well as the selection of surgical methods.