Robot-assisted partial nephrectomy: A single-center matched-pair analysis of the retroperitoneal versus the transperitoneal approach.

IF 1 Q4 UROLOGY & NEPHROLOGY

Turkish journal of urology Pub Date : 2021-07-01 DOI:10.5152/tud.2021.21008

Ahmed Eraky, Claudius Hamann, Nina N Harke, Marina Tropmann-Frick, Klaus-Peter Jünemann, Daniar Osmonov

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引用次数: 3

Abstract

Objective: Comparison of the retroperitoneal (RRPN) perioperative variables and the transperitoneal (TRPN) robot-assisted partial nephrectomy (RPN) using a matched-pair analysis.

Material and methods: A retrospective review was carried out for 224 patients who underwent RPN between 2014 and 2019. A matched-pair analysis was performed on 51 pairs of patients. The matching criteria were age, Charlson comorbidity index, body mass index, the grade of renal insufficiency, tumor diameter, and Preoperative Aspects and Dimensions Used for an Anatomical Classification of Renal Tumors score.

Results: The time to reach the renal hilum (P < .001), the overall complication rate (P ¼ .008), and the major complication rate (P ¼ .01) were lower in the RRPN group. The operative time was 143 vs 150minutes (P ¼ .63) in RRPN vs TRPN, respectively. Warm ischemia time was 10minutes in RRPN vs 12minutes in TRPN (P ¼ .07). Early unclamping was used in 71% in RRPN vs 48% in TRPN (P ¼ .02). The length of hospital stay was 6 days in both groups (P ¼ .11). The cases' complexity, the rate of positive surgical margins, and postoperative kidney function were comparable in both groups (P > .05).

Conclusion: The advantages of RRPN lie in the shorter time to reach the renal hilum and the lower complication rates; the comparability with the other parameters proves the safety and feasibility of the RRPN access for localized kidney tumors.

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机器人辅助部分肾切除术:腹膜后入路与经腹膜入路的单中心配对分析。

目的:采用配对分析比较腹膜后(RRPN)围手术期变量与腹膜后(TRPN)机器人辅助部分肾切除术(RPN)。材料与方法:对2014年至2019年接受RPN治疗的224例患者进行回顾性分析。对51对患者进行配对分析。匹配标准为年龄、Charlson合并症指数、体重指数、肾功能不全分级、肿瘤直径、术前肾肿瘤解剖分类方面和尺寸评分。结果:RRPN组到达肾门时间(P < 0.001)、总并发症发生率(P < 0.001)、主要并发症发生率(P < 0.01)均低于RRPN组。RRPN和TRPN的手术时间分别为143分钟和150分钟(P = 0.63)。RRPN组热缺血时间为10min, TRPN组为12min (P < 0.01)。RRPN中71%的患者使用了早期解夹，而TRPN中48%的患者使用了早期解夹(P < 0.01)。两组患者住院时间均为6 d (P < 0.05)。两组病例复杂程度、手术切缘阳性率、术后肾功能比较，差异无统计学意义(P > 0.05)。结论:RRPN的优点是到达肾门时间短，并发症发生率低;与其他参数的可比性证明了RRPN通路治疗局部肾肿瘤的安全性和可行性。

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来源期刊

Turkish journal of urology Medicine-Urology

CiteScore

2.10

自引率

0.00%

发文量

期刊介绍： The aim of the Turkish Journal of Urology is to contribute to the literature by publishing scientifically high-quality research articles as well as reviews, editorials, letters to the editor and case reports. The journal’s target audience includes, urology specialists, medical specialty fellows and other specialists and practitioners who are interested in the field of urology.