The Clinical Application Study Of One-position Robot-assisted Transabdominal Nephroureterectomy For Upper Urinary Tract Urothelial Carcinoma

Objective:To investigate the efficacy and safety of one-position transabdominal access RANU（robot-assisted radical nephroureterectomy）in the treatment of Upper Tract Urothelial Carcinoma（UTUC）,and provide a reference for clinical treatment.Methods:The clinical data related to UTUC patients admitted to the Second Department of Urology,First Hospital of Jilin University from July 2018 to December 2021 were retrospectively analyzed,and the surgeries were performed by the same operator with rich experience in laparoscopic surgery,and 73 patients were strictly screened according to the inclusion and exclusion criteria,including the robot-assisted laparoscopic group（RANU）27 cases,and46 cases in the conventional laparoscopic group（LRNU）,comparing the differences in general clinical data and perioperative data between the two groups.Results:There were no statistical differences in general clinical data such as age,gender,BMI,tumor site,tumor side,ASA classification,and history of abdominal surgery between the two groups（P > 0.05）,which were comparable.The RANU and LRNU groups were comparable in terms of operating time[185（176,208）min vs.132（115,153）min],number of lymph nodes [5.00（2.00,10.0）vs 0.5（0.00,4.00）],lymph nodes detection rate [22（81.48%）vs 23（50.00%）],and intraoperative blood transfusion [3（11.11%）vs 0（0.00%）] were statistically different（P < 0.05）;in the number of postoperative hospital days[5.00（4.00,6.00）days vs 5.00（5.00,6.00）days],pelvic drainage tube carrying time [5.0（3.0,5.0）days vs.4.0（3.0,4.0）days],renal fossa drainage tube carrying time [4.0（3.0,5.0）days vs.4.0（3.0,5.0）days],positive cystic sleeve margin rate（7.41% vs.10.87%）,short-term postoperative complications（18.5% vs.4.4%）were not statistically different（P > 0.05）.Conclusion:In the treatment of UTUC by one-position transabdominal approach RANU,the operation time was longer than that of LRNU,but the number of lymph nodes detected and the detection rate were significantly higher than that of LRNU;there were no significant differences between the two groups in terms of postoperative hospitalization time,tube duration and short-term complications,and one-position transabdominal approach RANU was a safe and effective surgical approach in terms of short-term postoperative results.