Robotic-assisted laparoscopic partial nephrectomy vs. laparoscopic and open partial nephrectomy: A single-site, two-surgeon, retrospective cohort study.

Kaveh Masoumi-Ravandi, Ross J. Mason, Ricardo A Rendon
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Abstract

INTRODUCTION In 2019, our center attempted to transition all partial nephrectomies (PNs) to robotic-assisted laparoscopic PN (RALPN). The purpose of this study was to compare RALPN outcomes to laparoscopic PN (LPN) and open PN (OPN) at our institution, as there is limited literature from Canadian centers. METHODS In this single-center, two-surgeon, retrospective cohort study, we compared RALPN outcomes during the early phase of our robotics program to OPN and LPN performed just before the introduction of RALPN. RESULTS A total of 106 patients underwent OPN, 83 LPN, and 82 RALPN during the study period. Median RALPN RENAL score was 7 vs. 6 for LPN (p<0.05) and 8 for OPN (p=0.10). Median RALPN length of stay (LOS) was two days vs. three and four days for LPN and OPN (p<0.05), respectively. OPN median procedure time was 104 minutes vs. 94 and 82 minutes for LPN and RALPN (p<0.05), respectively. Median OPN operating room (OR) time was 160 minutes vs. 150 and 146 minutes for LPN and RALPN (p<0.05), respectively. There were no significant differences in intraoperative (p=0.92) or postoperative complications rates (p=0.47). RALPN warm ischemia time (WIT) was 17 minutes vs 14.5 and 15 minutes for OPN and LPN (p<0.05), respectively. Median RALPN estimated blood loss (EBL) was 165 ml vs. 250 ml for OPN (p<0.05) and 125 ml for LPN (p=0.15). CONCLUSIONS Although patients who underwent RALPN had longer WIT, they had similar rates of complications, required less total OR time, and had shorter procedure time and LOS compared with OPN and LPN despite similar RENAL score compared to OPN and greater score than LPN.
机器人辅助腹腔镜肾部分切除术与腹腔镜和开放式肾部分切除术的比较:单病区、双外科医生、回顾性队列研究。
导言2019年,我们中心尝试将所有肾部分切除术(PN)过渡到机器人辅助腹腔镜PN(RALPN)。本研究的目的是比较本中心的 RALPN 与腹腔镜肾部分切除术(LPN)和开放式肾部分切除术(OPN)的结果,因为来自加拿大中心的文献有限。方法在这项单中心、双外科医生、回顾性队列研究中,我们比较了机器人项目早期阶段的 RALPN 结果与引入 RALPN 之前的 OPN 和 LPN 结果。RALPN RENAL 评分中位数为 7 分,LPN 为 6 分(P<0.05),OPN 为 8 分(P=0.10)。RALPN 中位住院时间(LOS)为两天,而 LPN 和 OPN 分别为三天和四天(P<0.05)。OPN手术时间中位数为104分钟,而LPN和RALPN分别为94分钟和82分钟(P<0.05)。OPN手术室(OR)中位时间为160分钟,而LPN和RALPN分别为150分钟和146分钟(P<0.05)。术中并发症发生率(P=0.92)和术后并发症发生率(P=0.47)无明显差异。RALPN 暖缺血时间(WIT)为 17 分钟,而 OPN 和 LPN 分别为 14.5 分钟和 15 分钟(P<0.05)。结论虽然接受 RALPN 的患者 WIT 时间较长,但并发症发生率相似,所需手术总时间较短,手术时间和 LOS 较 OPN 和 LPN 短,尽管 RENAL 评分与 OPN 相似,且高于 LPN。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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