| Background:Renal cancer is a more frequent urinary tract cancer,endangering human health,but with the in-depth study of this disease found that a considerable number of patients not because of tumor-related factors lead to decreased survival,but because of postoperative renal insufficiency,Kidney failure and other factors leading to death.We are in the pursuit of better surgical results at the same time,less trauma,better renal function protection,long-term survival rate is higher we continue to find the focus of the breakthrough.We have seen a variety of continuous innovation of new technologies,new technology,new materials continue to invest in the treatment of kidney cancer is also constantly changing the concept.Relying on social progress and technological development of kidney cancer has been able to do early diagnosis and treatment,so that the kidney tumor bid farewell to radical surgery dominate the world situation,creating a neonatal unit for the mainstream of the new benchmark;for minimally invasive surgery Continue to explore and let us from the traditional mirror of the continuous upgrade to complete the robotic technology as the representative of the artificial intelligence big leap.These rapid development and the effective integration of various new technologies not only make people see the continuous self-transcendence of medical progress,but also to the patient’s diagnosis and treatment to bring more choices and better results.However,the current industry for the retention of neonatal surgery of two minimally invasive surgery-robot-assisted and simple laparoscopic surgery,the two mainstream surgical methods between the clinical treatment of whether there is differences between the debate is still controversial,which surgical approach for Patients with long-term renal function protection will be better now still no conclusion.Objective:1.Comparison of two surgical efficacy differences between the robotic-assisted and the simple laparoscopy in renal cell cancer Nephron-sparing surgery.2.Evaluate which procedure can benefit patients with long-term kidney function.Methods:According to the retrospective clinical randomized controlled trial method,from June 2013 to June 2015,Xijing Hospital urology patients treated with renal cell carcinoma,the establishment of practical incorporation and exclusion rules,screening to meet the requirements of the receiving robot assistance And the traditional laparoscopic nephron surgery to retain the case of renal cell carcinoma patients.1.Collect,organize follow-up data,and classify data and results into Excel tables.2.Establish a separate database,the use of SPSS 19.0 statistical software analysis and processing of all data.3.Measurement data using t test to compare,using the mean ± standard deviation(± s)said.4.All the count data to take χ2 test method,take the results of P <0.05 was statistically significant.5.According to the results of differences,compared with the robot-assisted and traditional laparoscopy in kidney cancer to retain the clinical efficacy of neonatal surgery and study the prognosis of all patients to analyze the outcome.Results:1.Xijing Hospital Urology Surgery from June 2013 to June 2015 during the treatment of a total of 776 cases of renal cell carcinoma patients,including minimally invasive nephron neonatal operation in a total of 603 cases,198 cases of robotic surgery,laparoscopic surgery 402 cases,according to the inclusion Standard,robotic group of 68 cases,laparoscopic group of 107 cases.Both groups were successfully operated and the postoperative pathology was negative.During the follow-up period of life is good,no planting,distant metastasis,spread and local recurrence of the tumor and other cases.2.There were no significant differences in the low risk group,the robotic group and the laparoscopic group,but there was no significant difference between the low risk group and the laparoscopic group.The operation time,heat ischemia time and intraoperative blood loss were superior to those of laparoscopic group in the middle and high risk group,the robotic group.3.Cystatin C and creatinine are good indicators of renal function,although the two groups of patients before the comparison of creatinine levels,cystatin C levels were not obvious,but in the six months after surgery,1 year,2 years There were significant changes in follow-up results(P <0.05),the difference was statistically significant.Conclusion:1.Robotic assisted laparoscopic nephron neonatal surgery is safe and effective;2.In the treatment of complex renal neoplasms,robotic-assisted laparoscopic nephron nephronomy has a distinct advantage compared to laparoscopic nephron neonatal surgery alone,with shorter heat ischemia time,operative time,less bleeding.Reduced the occurrence of transit open or radical nephrectomy,resulting in a better therapeutic effect;3.The long-term protection of renal function in patients with laparoscopic laparoscopic surgery was better4.Cystatin C is a sensitive and effective indicator of changes in renal function,which is important for detecting changes in renal function in patients. |
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