Experience and prognosis analysis of robot-assisted laparoscopic nephron sparing surgery for complex cystic solid renal tumors
Objective:To evaluate the surgical experience,safety and prognosis of robot-assisted laparoscopic nephron sparing surgery for complex cystic solid renal tumors.Methods:The clinical data of 93 patients with complex cystic solid renal tumors who underwent robot-assisted laparoscopic nephron preservation surgery in Gen-eral Hospital of Peoples Liberation Army from January 2013 to December 2023 were retrospectively analyzed.The operation success rate,operation time,renal artery blocking time,intraoperative blood loss,intraoperative and postoperative blood transfusion volume,postoperative 3 days'drainage volume,postoperative extubation time,preoperative and postoperative GFR,postoperative hospital stay and perioperative complications were counted.Results:Among the 93 patients,68 were males and 25 were females.The average age was(47.66±12.63)years,ranging from 16 to 74 years.The maximum tumor diameter was 0.7-9.0 cm,with an average of(3.94±1.65)cm,46 cases on the left side and 47 cases on the right side.All operations were successful without conver-sion to open surgery.The operation time was 60-275 min,and the average time was(130.53±46.28)min.The time of renal artery occlusion was 7-68 min,and the average time was(20.84±9.28)min.Intraoperative blood loss was 5-550 mL,with an average of(77.47±110.78)mL.There was no case of intraoperative blood transfu-sion.The postoperative 3 d drainage volume was 0-970 mL,with an average of(64.00±97.79)mL.Postopera-tive extubation time was 2-8 d,with an average of(3.00±1.07)d.Postoperative hospital stay was 2-14 d,with an average of(4.62±1.65)d.The preoperative GFR was(94.58±16.28)mL/min and the postoperative GFR was(83.26±18.45)mL/min.Perioperative complications occurred in 2 patients.The 93 patients were fol-lowed up for a duration ranging from 3 to 123 months,with a median follow-up period of 39 months.The rate of loss to follow-up was recorded at 11.8％(11 out of 93),and only one case of recurrence was observed.No in-stances of distant metastasis were detected.Conclusion:Robot-assisted laparoscopic nephron sparing surgery for complex cystic solid renal tumors is safe and feasible,can effectively avoid postoperative complications,and has good long-term tumor control and recovery.
cystic solid renal tumorsrobot-assisted laparoscopic surgerynephron sparing surgery
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