Analysis Of Short-term Efficacy Of Three Different Surgical Methods Of Partial Nephrectomy In The Treatment Of Renal Cell Carcinoma

Objective : To compare the perioperative outcomes of Da-Vinci robot-assisted laparoscopic(RAPN),traditional laparoscopic partial nephrectomy(LPN)and open partial nephrectomy(OPN)in the treatment of localized renal cell carcinoma.Methods :The clinical data of 313 patients with T1-T2 stage renal cell carcinoma who underwent partial nephrectomy in the first affiliated Hospital of Chongqing Medical University from January 2012 to September 2019 were retrospectively reviewed,including RAPN group(n= 55),LPN group(n = 200)and OPN group(n = 58).The demographic data and pathological characters of the three groups were compared.Then,according to the R.E.N.A.L nephrometry score,the patients were divided into three groups with different tumor complexity: 91 cases of low risk group(range of 4 to 6),138 cases of moderate risk group(range of 7 to 9)and 84 cases of high risk group(range of 10 to 12).Evaluation the differences of the surgical indexes in each group.Results :The clinical data of 313 patients with T1-T2 stage renal cell carcinoma who underwent partial nephrectomy in the first affiliated Hospital of Chongqing Medical University from January 2012 to September 2019 were retrospectively reviewed,including RAPN group(n= 55),LPN group(n = 200)and OPN group(n = 58).The demographic data and pathological characters of the three groups were compared.Then,according to the R.E.N.A.L nephrometry score,the patients were divided into three groups with different tumor complexity: 91 cases of low risk group(range of 4 to 6),138 cases of moderate risk group(range of 7 to 9)and 84 cases of high risk group(range of 10 to 12).Evaluation the differences of the surgical indexes in each group.Conclusion : In partial nephrectomy,for medium-risk renal cell carcinoma,LPN and RAPN groups have obvious advantages than OPN groups in terms of postoperative hospital stay and postoperative hemoglobin reduction.For high-risk renal cell carcinoma,RAPN group has obvious advantages over LPN and OPN in warm ischemia time,postoperative estimated glomerular filtration rate reduction,postoperative hemoglobin reduction,postoperative hospital stay and trifecta compliance rate(P < 0.05).Robotic-assisted laparoscopic partial nephrectomy has the advantages of less renal function damage and faster postoperative recovery for the treatment of high risk renal cell carcinoma.