Comparisons of the safety and effectiveness between robot-assisted and laparoscopic partial nephrectomy for cT2a renal cancer
Objective:To compare the safety and effectiveness between robot-assisted nephrectomy and laparo-scopic nephrectomy in the treatment of cT2a renal carcinoma,and to analyse the prognosis of these patients.Methods:A retrospective analysis was performed on 33 patients with stage cT2a renal cancer who received ne-phrectomy in the Urology Department of Shanghai Renji Hospital from January 2019 to January 2021.Surgical methods included robot-assisted partial nephrectomy(RAPN)and laparoscopic partial nephrectomy(LPN).Base-line characteristics,perioperative data and postoperative outcomes were compared between two surgical methods by t test and x2 test in SPSS software.Results:There was no significant difference between the robot group(RAPN)and the laparoscopic group(LPN)in general clinical data related factors(P＞0.05).The operative time of RAPN group([138.15±19.94]min)was less than that of LPN group([167.15±38.49]min),and the intraopera-tive blood loss of RAPN group([228.55±78.16]mL)was less than that of LPN group([324.54±107.50]mL).The differences were statistically significant(P＜0.05).The duration of hot ischemia in LPN group([33.00±4.14]min)was significantly longer than that in RAPN group([22.05±4.55]min),and the difference was statistically significant(P＜0.05).There was no statistically significant difference in the incidence of postoperative serious complica-tions(Clavien-Dindo grade ≥3)between the two groups(P＞0.05).There was no significant difference in preoperative serum creatinine(Scr)between the two groups(P=0.70),but the Scr in the RAPN group was significantly lower than that in the LPN group on the first day after surgery(P=0.001).There was significant difference in the incidence of chronic kidney disease 3 years after operation between the two groups(P＜0.05).After 3 years of follow-up,there was no significant difference in 3-year recurrence or metastasis rate between RAPN group and LPN group(P＞0.05).Conclusion:RAPN and LPN in the treatment of stage cT2a renal cancer are generally safe and effective,and both techniques can achieve good surgical results operated by experienced physicians.Compared with laparos-copy alone,robot-assisted nephrectomy has a shorter hot ischemia time,can fully and effectively protect patients'postoperative renal function,and has a lower incidence of long-term postoperative nephro-related diseases.
partial nephrectomyrobot-assistedlaparoscopycT2a renal cancer
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