基于MAP评分对机器人辅助肾部分切除术治疗T1期肾肿瘤的疗效分析

Analysis of efficacy of robot-assisted partial nephrectomy for T1 renal tumors based on Mayo adhesive probabilityscore

目的:比较不同MAP评分情况下机器人辅助肾部分切除术(RAPN)处理T1期肾肿瘤的手术结果和疗效。方法:回顾性分析我院2020年1月至2022年12月120例行RAPN患者的临床资料。根据患者术前影像资料予以梅奥粘连评分(MAP),分为MAP低分组(81例)和高分组(39例),比较MAP低分组和高分组患者基本资料和手术相关指标的差异。结果:MAP高分组相比MAP低分组男性占比[89.7%(35/39)vs.63.0%(51/81]、年龄[(58.1±10.5)岁vs.(51.7±11.9)岁]、体质量指数[(26.1±3.2)kg/m^(2)vs.(24.6±3.9)kg/m^(2)]、高血压病史占比[53.8%(21/39)vs.32.1%(26/81)]、手术时间[(154.9±34.6)min vs.(132.3±33.3)min]、术中出血量[50(30,100)ml vs.50(20,50)ml]以及术前白细胞[(6.3±1.5)×10^(9)/L vs.(5.7±1.6)×10^(9)/L]、血红蛋白[(140.9±13.8)g/L vs.(134.4±18.0)g/L]水平高,差异均具有统计学意义(P<0.05),其余观察指标差异无明显统计学意义(P>0.05)。结论:MAP评分对肾周粘连脂肪(APF)具有一定预测效果,RAPN处理不同MAP评分的T1期肾肿瘤安全有效,MAP≥3分时手术难度增加。

Objective:To compare the surgical outcomes and efficacy of RAPN for T1 stage renal tumors with different MAP scores.Methods:Clinical data of 120 patients who underwent robot-assisted partial nephrectomy in our hospital from January 2020 to December 2022 were.retrospectively analysed.According to the Mayo adhesive probability(MAP)score of preoperative imaging,they were divided into low-score(81 cases)and high-score group(39 cases).The basic information and surgery-related indicators were compared between the two groups.Results:There were statistically significant differences between the high-score and low-score MAP group inthe proportion of male[89.7%(35/39)vs.63.0%(51/81],age[(58.1±10.5)year vs.(51.7±11.9)year],BMI[(26.1±3.2)kg/m^(2)vs.(24.6±3.9)kg/m^(2)],proportion of hypertension patients[53.8%(21/39)vs.32.1%(26/81)],surgical time[(154.9±34.6)min vs.(132.3±33.3)min],intraoperative blood loss[50(30,100)ml vs.50(20,50)ml],levels of preoperative white blood cells[(6.3±1.5)×10^(9)/L vs.(5.7±1.6)×10^(9)/L]and hemoglobin[(140.9±13.8)g/L vs.(134.4±18.0)g/L](P<0.05),while there was no significant statistical differences in the remaining observed indicators between the two groups(P>0.05).Conclusion:The MAP score has a certain predictive effect on adherent perinephric fat,and robotic-assisted partial nephrectomy(RAPN)is safe and effective for treating T1 renal tumors with different MAP scores.MAP≥3 scores increases the difficulty of the surgery.