Comparison of robotic-assisted laparoscopic partial nephrectomy versus laparoscopic partial nephrectomy for the treatment of renal angiomyolipoma

doi:10.3877/cma.j.issn.1674-3253.2022.04.005

Abstract

Abstract:

Objective

To compare the safety and efficacy of robot assisted partial nephrectomy (RAPN) and laparoscopic partial nephrectomy (LPN) in treatment of patients with renal angiomyolipoma (RAML).

Methods

198 patients diagnosed with renal angiomyolipoma admitted to our hospital from January 2016 to August 2021 were collected, including 80 in the robot assisted partial nephrectomy group and 118 in the laparoscopic partial nephrectomy group. After propensity score matching, the clinical data were analyzed and compared between the two groups.

Results

Among 198 cases, 3 cases were converted to open partial nephrectomy (including 2 cases of LPN and 1 case of RAPN), 1 case of LPN injured ureter during operation, and the rest were successfully completed. The warm ischemia time in RAPN group was significantly less than that in LPN group. The percentage of postoperative Hb loss and eGFR loss in RAPN group were significantly lower than those in LPN group (P<0.05). There was no significant difference between the two groups in operation time, estimated blood loss, intraoperative and postoperative blood transfusion rate, postoperative complications rate, postoperative drainage volume, catheterization time, gastrointestinal functional recovery time and length of postoperative hospital stay.

Conclusion

Compared with LPN, RAPN has significant advantages in treating patients with renal angiomyolipoma in terms of less blood loss, shorter warm ischemia time and greater preservation of renal function.

Key words: Robot-Assisted Sugery, Laparoscopy, Angiomyolipoma, Propensity score

Wenhui Lu, Junlong Zhang, Lingwu Chen, Shaopeng Qiu, Wei Chen, Junhang Luo, Xu Chen, Yu Chen. Comparison of robotic-assisted laparoscopic partial nephrectomy versus laparoscopic partial nephrectomy for the treatment of renal angiomyolipoma[J]. Chinese Journal of Endourology(Electronic Edition), 2022, 16(04): 306-310.

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URL: https://zhqjmnmwkzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-3253.2022.04.005

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References 17

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指标		匹配前			匹配后
指标		RAPN组	LPN组	P值	RAPN组	LPN组	P值
例数		80	118		61	61
年龄[岁，(±s)]		44±12	46±12	0.358	44±11.	43±12	0.724
性别(例)
	男	18	16	0.102	14	10	0.362
	女	62	102	0.102	47	51	0.362
BMI[kg/m²，(±s]		22.5±3.10	22.6±3.10	0.719	22.6±2.90	22.6±3.00	0.968
瘤体最大径[mm，M(Q)]		57(38，78)	46(36，60)	0.025	55(35，67)	51(40，61)	0.607
RENAL评分[M(Q)]		7(5，9)	6(5，7)	0.01	6(5，8)	6(5，8)	0.726
切除瘤体数量[个，M(Q)]		1.0(1.0，1.0)	1.0(1.0，1.0)	0.164	1.0(1.0，1.0)	1.0(1.0，1.0)	0.169

指标		匹配前			匹配后
指标		RAPN组	LPN组	P值	RAPN组	LPN组	P值
例数		80	118		61	61
年龄[岁，(±s)]		44±12	46±12	0.358	44±11.	43±12	0.724
性别(例)
	男	18	16	0.102	14	10	0.362
	女	62	102	0.102	47	51	0.362
BMI[kg/m²，(±s]		22.5±3.10	22.6±3.10	0.719	22.6±2.90	22.6±3.00	0.968
瘤体最大径[mm，M(Q)]		57(38，78)	46(36，60)	0.025	55(35，67)	51(40，61)	0.607
RENAL评分[M(Q)]		7(5，9)	6(5，7)	0.01	6(5，8)	6(5，8)	0.726
切除瘤体数量[个，M(Q)]		1.0(1.0，1.0)	1.0(1.0，1.0)	0.164	1.0(1.0，1.0)	1.0(1.0，1.0)	0.169

组别	例数	手术时间[min，M(Q)]	术中估计出血量[ml，M(Q)]	热缺血时间[min，M(Q)]	术中转开放(例)	术中输血(例)
RAPN组	61	130(95，165)0	50(25，65)	08(13，23)	0	2
LPN组	61	122(100，147)	50(20，80)	25(18，30)	2	1
统计值		Z=0.917	Z=0.660	Z=3.372	-	χ²=0.001
P值		0.359	0.509	<0.001	0.496	1

组别	例数	手术时间[min，M(Q)]	术中估计出血量[ml，M(Q)]	热缺血时间[min，M(Q)]	术中转开放(例)	术中输血(例)
RAPN组	61	130(95，165)0	50(25，65)	08(13，23)	0	2
LPN组	61	122(100，147)	50(20，80)	25(18，30)	2	1
统计值		Z=0.917	Z=0.660	Z=3.372	-	χ²=0.001
P值		0.359	0.509	<0.001	0.496	1

组别	例数	术后3天引流量[ml，M(Q)]	引流管留置时间[d，M(Q)]	胃肠恢复时间[d，M(Q)]	术后输血(例)	术后并发症(例)	术后住院[d，M(Q)]	术后Hb差值百分比[%，M(Q)]	术后eGFR差值百分比[%，M(Q)]
RAPN组	61	164(82，300)	3.0(3.0，4.0)	2.0(1.0，2.0)	0	5	6.0(5.0，7.0)	-13.3(-17.9，-8.3)	-9.7(-17.6，4.2)0
LPN组	61	174(93，341)	4.0(3.0，5.0)	2.0(1.0，2.0)	3	6	6.0(5.0，8.0)	-18.5(-29.3，-7.5)	-15.7(-22.5，-11.2)
统计值		Z=0.526	Z=-0.918	Z=-0.988	-	χ²=0.1	Z=-0.957	Z=-2.471	Z=-3.367
P值		0.599	0.359	0.323	0.244	0.752	0.339	0.013	<0.001

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