Comparative study of single center between robotic assisted laparoscopic partial nephrectomy and laparoscopic partial nephrectomy

doi:10.3877/cma.j.issn.1674-3253.2017.02.003

Abstract

Abstract:

Objective

To comparatively analyze the clinical efficacy and safety between robot-assisted laparoscopic partial nephrectomy (RAPN) and laparoscopic partial nephrectomy (LPN)in treating renal cancer, aiming to investigate the advantages and application values of RAPN.

Methods

Clinical data of patients undergoing RAPN (n=61) and LPN (n=32) in the Department of Urology of Xijing Hospital between March 2013 and April 2015 were retrospectively analyzed. Age, body mass index (BMI), R.E.N.A.L. nephrometry score, operation time, warm ischemia time, hemorrhage volume, length of hospital stay, postoperative complication and postoperative follow-up status were statistically analyzed and compared between the two groups.

Results

No significant differences were identified in age, BMI, tumor diameter and warm ischemia time between the two groups (all P>0.05). In the RAPN group, R.E.N.A.L. nephrometry score was significantly higher (P<0.05) and operation time, hemorrhage volume and length of hospital stay were significantly less compared with those in the LPN group (all P<0.05). In the patients with tumor diameter ≤4 cm, no significant differences were documented regard to age, BMI, tumor diameter and warm ischemia time between the RAPN and LPN groups (all P>0.05). In the RAPN group, R.E.N.A.L. nephrometry score was significantly higher (P<0.05), whereas operation time, hemorrhage volume and length of hospital stay were significantly less than those in the LPN group (all P<0.05). In the RAPN group, no significant differences were identified in BMI, hemorrhage volume and length of hospital stay (all P>0.05), whereas age, R.E.N.A.L. nephrometry score, operation time and warm ischemia time significantly differed between patients with tumor diameter ≤4 cm and >4 cm (all P<0.05). In the RAPN group, two patients were complicated with intestinal obstruction after surgery and one was complicated with cerebral infarction. In the LPN group, one case was complicated with acute cerebral infarction (P>0.05). In the RAPN group, two patients had recurrence and metastasis and one died postoperatively. The remaining patients neither diednor presented with disease progression.

Conclusion

RAPN is an efficacious and feasible surgical technique in the treatment of renal carcinoma, which is superior to LPN.

Key words: Renal cell carcinoma, Robot assisted laparoscopy, Laparoscopy, Partial nephrectomy

Zhibin Li, Geng Zhang, Dongli Ruan, Kepu Liu, Shuaijun Ma, Ping Meng, Longlong Zhang, Xiaojian Yang, Weijun Qin, Jianlin Yuan. Comparative study of single center between robotic assisted laparoscopic partial nephrectomy and laparoscopic partial nephrectomy[J]. Chinese Journal of Endourology(Electronic Edition), 2017, 11(02): 81-85.

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References 15

[1]	那彦群，叶章群，孙颖浩. 2014版中国泌尿外科疾病诊断治疗指南[M].北京:人民卫生出版社, 2013: 3-19.
[2]	Li W, Cheng Y, Cheng Y, et al. Clinical efficacy of radical nephrectomy versus nephron-sparing surgery on localized renal cell carcinoma [J]. Eur J Med Res, 2014, 19(1):58.
[3]	Sánchez-Coral M, Bá ez-Reyes JR, García-Cano E, et al. Experience in nephron-sparing surgery in patients with small renal tumors [J]. Cir Cir, 2015, 83(4):297-302.
[4]	袁建林，孟平.机器人辅助腹腔镜手术在泌尿外科的应用[J].实用医院临床杂志, 2015, 2(1):5-8.
[5]	Boylu U, Basatac C, Yildirim U, et al. Comparison of surgical, functional, and oncological outcomes of open and robot-assisted partial nephrectomy [J]. J Minim Access Surg, 2015, 11(1):72-77.
[6]	ömer Acar, Esin öztürk Isik, Tuna Mut, et al. Comparison of the trifecta outcomes of robotic and open nephron-sparing surgeries performed in the robotic era of a single institution[J]. Springerplus, 2015, 4(1):472.
[7]	Zhang X, Shen Z, Zhong S, et al. Comparison of perioperative outcomes of robot-assisted vs laparoscopic partial nephrectomy: a meta-analysis[J]. BJU Int, 2013, 112(8):1133-1142.
[8]	Zhang Xiaolong, Yan Jiajun, Ren Yu, et al. Robot-assisted versus laparoscopic partial nephrectomy for localized renal tumors: a meta-analysis[J]. Int J Clin Exp Med, 2014, 7(12):4770-4779.
[9]	Petros F, Sukumar S, Haber GP, et al. Multi-institutional analysis of robot-assisted partial nephrectomy for renal tumors >4 cm versus ≤4 cm in 445 consecutive patients[J]. J Endourol, 2012, 26(6):642-646.
[10]	Masson-Lecomte A, Yates R, Bensalah K, et al. Robot-assisted laparoscopic nephron sparing surgery for tumors over 4 cm: operative results and preliminary oncologic outcomes from a multicentre French study[J]. Eur J Surg Oncol, 2013, 39(7):799-803.
[11]	Shin Jea, Ko Jin, Kim Sun, et al. Trends in the use of Nephron-Sparing surgery over 7 years: an analysis using the R.E.N.A.L. nephrometry scoring system[J]. PLoS One, 2015, 10(11):e0141709.
[12]	Zhou L, Guo J, Wang H, et al. The zhongshan score: a novel and simple anatomic classification system to predict perioperative outcomes of nephron-sparing surgery[J]. Medicine (Baltimore), 2015, 94(5):e506.
[13]	Azhar RA, Gill IS, Aron M. Robotic nephron-sparing surgery for renal tumors: Current status[J]. Indian J Urol, 2014, 30(3):275-282.
[14]	Tanagho YS, Bhayani SB, Figenshau RS. Robot-assisted partial nephrectomy in contemporary practice [J]. Front Oncol, 2013, 2:213.
[15]	Alenezi N, Karim Omer. Role of intra-operative contrast-enhanced ultrasound (CEUS) in robotic-assisted nephron-sparing surgery[J]. J Robot Surg, 2015, 9(1):1-10.

分组	例数	年龄（岁）	BMI（kg/m²）	肿瘤直径（cm）	R.E.N.A.L.评分	手术时间（min）	温缺血时间（min）	出血量（ml）	住院时间（d）
RAPN组	61	54±13	25±4	3.7±1.4	7.4±1.1	128±48	20±9	81±46	5.1±0.9
LPN组	32	55±12	25±4	3.2±1.3	7.1±1.2	152±69	21±6	168±65	6.0±1.1
t值	?	-0.46	-0.53	1.94	-1.16	-2.02	-0.47	-3.25	-4.10
P值	?	0.65	0.59	0.06	0.25	0.043	0.64	0.002	<0.001

分组	例数	年龄（岁）	BMI（kg/m²）	肿瘤直径（cm）	R.E.N.A.L.评分	手术时间（min）	温缺血时间（min）	出血量（ml）	住院时间（d）
RAPN组	61	54±13	25±4	3.7±1.4	7.4±1.1	128±48	20±9	81±46	5.1±0.9
LPN组	32	55±12	25±4	3.2±1.3	7.1±1.2	152±69	21±6	168±65	6.0±1.1
t值	?	-0.46	-0.53	1.94	-1.16	-2.02	-0.47	-3.25	-4.10
P值	?	0.65	0.59	0.06	0.25	0.043	0.64	0.002	<0.001

分组	例数	年龄（岁）	BMI（kg/m²）	肿瘤直径（cm）	R.E.N.A.L.评分	手术时间（min）	温缺血时间（min）	出血量（ml）	住院时间（d）
RAPN组	40	51±14	24±4	3.0±0.7	7.2±0.9	102±14	18±8	74±35	5.2±0.8
LPN组	27	56±11	25±3	2.7±0.8	7.0±1.1	146±59	21±6	178±94	6.1±1.2
t值	?	-1.65	-1.01	1.18	-0.9	-4.55	-1.36	-3.23	-3.78
P值	?	0.1	0.32	0.24	<0.01	<0.01	0.18	0.002	<0.01

分组	例数	年龄（岁）	BMI（kg/m²）	肿瘤直径（cm）	R.E.N.A.L.评分	手术时间（min）	温缺血时间（min）	出血量（ml）	住院时间（d）
RAPN组	40	51±14	24±4	3.0±0.7	7.2±0.9	102±14	18±8	74±35	5.2±0.8
LPN组	27	56±11	25±3	2.7±0.8	7.0±1.1	146±59	21±6	178±94	6.1±1.2
t值	?	-1.65	-1.01	1.18	-0.9	-4.55	-1.36	-3.23	-3.78
P值	?	0.1	0.32	0.24	<0.01	<0.01	0.18	0.002	<0.01

分组	例数	年龄（岁）	BMI（kg/m²）	R.E.N.A.L.评分	手术时间（min）	温缺血时间（min）	出血量（ml）	住院时间（d）
>4 cm组	21	60±11	25±4	8.1±0.9	177±50	24±11	95±45	5.1±1.1
≤4 cm组	40	51±14	24±4	7.0±1.1	102±14	18±8	74±30	5.2±0.8
t值	?	2.57	0.80	4.34	9.02	2.27	1.41	-0.5
P值	?	0.013	0.43	<0.01	<0.01	0.027	0.16	0.62

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