Comparative Study Of Robot-assisted Nephroureterectomy And Retroperitoneal Laparoscopic Nephroureterectomy In The Treatment Of Upper Tract Urothelial Carcinoma

Purpose:To compare the efficacy and safety of robot-assisted nephroureterectomy（RANU）and retroperitoneal laparoscopic nephroureterectomy（RLNU）in the treatment of upper tract urothelial carcinoma,and provide preference for clinical treatment.Methods:Collect and analyze the clinical data of 40 patients diagnosed with upper tract urothelial carcinoma by pathology after surgery in the 1^st department of urology of our hospital from June of 2019 to October of 2021 retrospectively.According to the inclusion and exclusion criteria,40 cases were included and 20 of them underwent RANU while the others underwent RLNU.There are 10 males and 10 females in RANU group,aged 64.70±2.38,BMI 24.00±4.41kg/m~2.There are 13cases of ureteral tumor,6 cases of renal pelvis tumor and 1 case of renal pelvis and ureter tumor in RANU group.The size of them is2.71±1.05cm.There are 9 males and 11 females in RLNU group,aged68.30±2.38,BMI 23.20±3.12kg/m~2.There are 12 cases of ureteral tumor,7 cases of renal pelvis tumor and 1 case of renal pelvis and ureter tumor in RLNU group.The size of them is 3.59±1.93cm.Analyze the efficacy and safety of two groups by comparing the gender,age,body mass index,tumor size,tumor location,operation time,estimated blood loss,postoperative length of hospital stays,catheter indwelling time,drainage tube indwelling time,anal exhaust time and analgesic using time.Results:There was no significant difference between group RANU and group RLNU in terms of gender,age,body mass index,tumor size and tumor location.（P>0.05）There was no significant difference between two groups in terms of postoperative length of hospital stay[10（3.0）d vs 8（2.75）d],catheter indwelling time[7（0）d vs 7（0）d],anal exhaust time[2（1.0）d vs 2（1.0）d].（P>0.05）There were significant differences between two groups in terms of operation time（226.50±45.69min vs 184.75±26.37min）,estimated blood loss（87.35±59.08ml vs 125.84±57.63ml）,drainage tube indwelling time,analgesic using time[1（1.0）d vs 3（1.0）d].（P<0.05）Conclusion:Compared with RLNU,the operative blood loss of RANU is less,the drainage tube indwelling time is shorter and analgesics is less needed.Compared with RANU,it takes less time to perform RLNU.Both of two approaches are efficacious and safe.