腹腔镜与机器人辅助腹腔镜保留肾单位手术治疗复杂性肾癌的临床疗效比较

Comparison of perioperative outcomes for complex renal cell carcinoma between laparoscopic and robot-assisted laparoscopic partial nephrectomy

目的:比较腹腔镜保留肾单位手术(LPN)与机器人辅助腹腔镜保留肾单位手术(RAPN)在治疗复杂性肾癌中的临床疗效。方法:回顾性分析我院2015年12月~2016年12月收治入院的74例局限性复杂肾癌患者接受LPN或RAPN的临床资料,比较两种术式在中转开放或根治性肾切率、热缺血时间、手术时间、术中出血量、术后并发症发生率、住院时间等指标上的不同。结果:LPN组共35例,RAPN组共39例,两组术前影像学评估的R.E.N.A.L.评分差异无统计学意义,RAPN组在中转开放或根治性肾切例数(1vs.6)、热缺血时间[(20.4±6.4)min vs.(27.1±8.6)min]、手术时间[(155.7±48.6)min vs.(178.5±59.7)min]、术中出血量[(49.9±21.2)ml vs.(75.7±37.7)ml]方面显著优于LPN组,而在术后并发症发生率、住院时间上则差异均无统计学意义。结论:在治疗复杂性肾癌方面,LPN和RAPN均是安全有效的方法,RAPN的临床疗效优于LPN。

Objective：To compare perioperative outcomes between laparoscopic partial nephrectomy（LPN）and robot-assisted laparoscopic partial nephrectomy（RAPN）for complex renal cell carcinoma.Method：A retrospective study of 74 patients who received LPN or RAPN with complex renal cell carcinoma from December 2015 to December 2016 was conducted.The rate of conversion to open or radical nephrectomy,warm ischemia time,operating time,blood loss,postoperative complications and hospital stay were evaluated between two groups.Result：Demographic characteristics including R.E.N.A.L.scores was similar for 35 LPN and 39 RAPN,but RAPN achieved better results in conversion cases（1vs.6）,warm ischemia time [（20.4±6.4）min vs.（27.1±8.6）min],operating time [（155.7±48.6）min vs.（178.5±59.7）min]and blood loss [（49.9±21.2）ml vs.（75.7±37.7）ml].Conclusion：LPN and RAPN were both considered as safe and effective methods to cure complex renal cell carcinoma,but RAPN provided better perioperative outcomes.