Laparoscopic Nephron-sparing Surgery In The Treatment Of Complex Renal Carcinoma

Objective: To investigate the safety and efficacy of laparoscopic nephron-sparing surgery in complex renal carcinoma.Methods: The clinical data of renal carcinoma patients who underwent laparoscopic nephron-sparing surgery from August 2014 to August 2020 in First Affiliated Hospital of Xinjiang Medical University were retrospectively analyzed.RENAL Nephrometry Scoring System was used to represent tumor anatomy and complexity in the operation.According to the score,the patients were divided into three groups,the low score group(4-6 points),the middle score group(7-9 points),the high score group(10-12 points).The data that was collected between each group was compared and analyzed,include the operation time,Bleeding volume,postoperative complications,positive rate of resection margins,renal volume retention rate,and postoperative GFR drop rate are less than 10%.Analysis of postoperative recurrence and distant metastasis between the low score group and the high score group.Results: All 104 patients in this study had successfully completed the operation,with complete clinical data,including 41(39.42%)in the low score group,39(37.5%)in the middle score group and 24(23.08%).in the high score group. The three groups had statistically significant differences in the renal volume retention rate(0.88±0.12,0.84±0.11,0.77±0.14,F=7.87,P<0.05),but in the operation time,intraoperative blood loss,postoperative complications,and the rate of marginal positive rate,local recurrence or distant metastasis,and the actual GFR drop of less than 10% after surgery did not show statistical significance among each group.Conclusion: Laparoscopic nephron-sparing surgery is safe and feasible in the treatment of complex renal carcinoma.Although the renal volume retention rate is not as effective as simple renal cancer,it can have the same long-term curative effect and prognosis as simple renal carcinoma.