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經(jīng)腹膜后途徑機器人輔助腹腔鏡下腎部分切除術治療腹側(cè)和背側(cè)腎腫瘤的療效分析

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Clinical efficacy of retroperitoneal robot-assisted laparoscopic partial nephrectomy for ventral and dorsal renal tumor

CHEN Haonan，YANG Xiao，LIU Peikun，CAI Lingkai，ZHUANG Juntao，WU Qikai，CAO Qiang，LI Pengchao，LYU Qiang

[Department of Urology，The First Affiliated Hospital of Nanjing Medical University （Jiangsu Province Hospital），Nanjing 210029，China]

ABSTRACT：Objective To compare the efficacy of retroperitoneal robot-assisted laparoscopic partial nephrectomy （RALPN） in the treatment of ventral and dorsal renal tumor.Methods The clinical data of 131 patients with renal tumor who underwent retroperitoneal RALPN at our hospital during Jan.2021 and Feb.2024 were retrospectively analyzed.The patients were divided into the ventral renal tumor group （n=35） and dorsal renal tumor group （n=96） according to preoperative images.Perioperative outcomes and prognosis were compared between the two groups.Results All 131 surgeries were successfully completed without conversion to open surgery or abdominal organ injury.There were no significant differences in warm ischemia time [median （interquartile range，IQR）：20（16.75） min vs. 22（IQR：15.25） min]，operation time[57.0（IQR：29.5） min vs. 58.5（IQR：39.75） min]，estimated intraoperative blood loss [50（IQR：80） mL vs. 50（IQR：80） mL]，proportion of patients with intraoperative blood transfusion （0 vs. 2.1%），proportion of patients using four arms during operation （42.9% vs. 37.5%），postoperative reduction of hemoglobin （Hb）[（－12.9±9.0）g/L vs. （－11.5±9.4） g/L]，reduction of estimated glomerular filtration rate （eGFR）[（－3.8±12.4 ） mL/min vs. （－7.0±13.6） mL/min]，postoperative hospital stay [4（IQR：0） d vs.4（IQR：2） d]，and proportion of meeting “Trifecta” criteria （94.3% vs. 86.5%，P＞0.05）.During the median follow-up of 9.8（5.5，24.0） months，no death occurred，and no recurrence or metastasis were observed except that bone metastasis occurred in 1 patient in the dorsal renal tumor group.Conclusion Both ventral and dorsal renal tumors can be treated with retroperitoneal RALPN，and the surgical outcomes of both are comparable.

KEY WORDS：renal tumor; retroperitoneal; robotics; partial nephrectomy; ventral renal tumor; dorsal renal tumor

摘要：目的 比較經(jīng)腹膜后途徑機器人輔助腹腔鏡下腎部分切除術治療腹側(cè)和背側(cè)腎腫瘤的療效。（剩余8945字）

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