Renorrafia sin sutura frente a renorrafia convencional con sutura en nefrectomía parcial robóti̇ca sin clampaje: análisis unicéntrico de emparejamiento por puntuación de propensión

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Actas urologicas espanolas Pub Date : 2025-03-01 DOI:10.1016/j.acuro.2025.501704

S. Kilic, M. Ates

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引用次数: 0

Abstract

Introduction and objectives

Suture renorrhaphy persists as time-consuming in partial nephrectomy (PN) and carries the risk of renal arterial damage and renal functional loss. This study aims to compare the functional and oncological outcomes of the clampless and sutureless robotic PN (sRPN) with clampless conventional suture renorrhaphy RPN (cRPN).

Patients

A total of 173 consecutive patients who underwent RPN between January 2019 and December 2023 were reviewed from our center's database. Seventy six clampless (sutureless: 23; conventional suture renorrhaphy: 53) RPN were identified. A propensity score matched-pair analysis (PSM) was performed to homogenize the ingredients of the groups. Comprehensive evaluations of perioperative variables, functional and oncological results were performed before and after the PSM between the sRPN and cRPN.

Results

Before the PSM, median console time was 10 minutes shorter in the sRPN group but was not statistically significant. Estimated median blood loss was significantly lower in the sRPN group (P < .05). After PSM, 22 patients were matched in each group and all of the preoperative baseline characteristics were similar. Ratio of interpolar lines located tumors was higher in sRPN group (68.2% vs 31.2%) (P < .05). Median tumor diameter was 3 (1.5-7) cm in each group. The trifecta achievement ratios were 90.9% and 77.2% for sRPN and cRPN groups, respectively (P > .05). There were no differences in terms of median console times, estimated blood loss, drain removal times or eGFR changes.

Conclusions

In the treatment of small renal masses with clampless RPN, the sutureless technique can be applied with similar complication rates and functional, oncological outcomes as conventional sutured renorophy.

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无缝合再引流与常规缝合机器人部分肾切除术s ca无夹钳：单中心倾向评分配对分析

简介和目的在部分肾切除术（PN）中，缝合肾修补术一直是耗时的，并且存在肾动脉损伤和肾功能丧失的风险。本研究旨在比较无夹和无缝线机器人PN （sRPN）与无夹常规缝合再缝合RPN （cRPN）的功能和肿瘤结果。从我们中心的数据库中回顾了2019年1月至2023年12月期间共173例连续接受RPN的患者。76个无夹(无缝线：23；常规缝合再缝合术：53例发现RPN。采用倾向评分配对分析（PSM）使各组成分均质化。在sRPN和cRPN之间的PSM前后进行围手术期变量、功能和肿瘤结果的综合评估。结果PSM前，sRPN组的中位治疗时间缩短了10分钟，但差异无统计学意义。sRPN组估计中位失血量显著降低(P <；. 05)。PSM后，每组匹配22例患者，所有术前基线特征相似。sRPN组极间线定位肿瘤的比例更高（68.2% vs 31.2%） (P <；. 05)。两组肿瘤中位直径均为3 (1.5 ~ 7)cm。sRPN组和cRPN组的三连冠完成率分别为90.9%和77.2% (P >；. 05)。两组间的中位镇静时间、估计失血量、引流时间或eGFR变化均无差异。结论无缝线技术应用于无夹钳肾穿刺治疗小肾肿块，其并发症发生率和功能、肿瘤预后与常规缝合肾穿刺相似。

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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来源期刊

Actas urologicas espanolas UROLOGY & NEPHROLOGY-

CiteScore

1.90

自引率

0.00%

发文量

审稿时长

46 days

期刊介绍： Actas Urológicas Españolas is an international journal dedicated to urological diseases and renal transplant. It has been the official publication of the Spanish Urology Association since 1974 and of the American Urology Confederation since 2008. Its articles cover all aspects related to urology. Actas Urológicas Españolas, governed by the peer review system (double blinded), is published online in Spanish and English. Consequently, manuscripts may be sent in Spanish or English and bidirectional free cost translation will be provided.