Comparison Of Robot Assisted Retroperitoneal Laparoscopic Partial Nephrectomy With Traditional Retroperitoneal Laparoscopic Partial Nephrectomy

Objective:To compare da Vinci robot-assisted retroperitoneal laparoscopic partial nephrectomy(RAPN)and conventional retroperitoneal laparoscopic partial nephrectomy(Retroperitoneal Laparoscopic Partial Nephrectomy,LPN)in the treatment of renal tumors to provide a reference for clinicians’ choice.Methods:In this study,we analyzed the clinical data data of 36 renal cancer patients admitted to the second ward of urology department of our hospital from September 2021 to December 2022 by retrospective study,and divided them into LPN group(n=14)and RAPN group(n=22)according to the different surgical methods,and compared and analyzed the gender,age,BMI,affected side,maximum tumor diameter,RENAL score,postoperative incision positivity rate,postoperative hospital stay,hospital costs,operative time,intraoperative bleeding,thermal ischemia time,gastrointestinal function recovery time,and whether there were differences in postoperative complications(urinary fistula,bleeding,bleeding infection in the operative area,arteriovenous fistula).RESULTS:One case was converted to open partial nephrectomy in the robot-assisted retropubic partial nephrectomy group(N=22)and one case was converted to radical resection in the conventional retropubic partial nephrectomy group(N=14),and the rest were completed as planned.There was no statistical difference in age,gender,BMI,maximum tumor diameter,and postoperative creatinine change rate between the two groups(P>0.05).intraoperative WIT,EBL,gastrointestinal recovery time,and postoperative hospital stay were less in the RAPN group than in the LPN group,and the difference was statistically significant(P<0.05).surgical cost and RENAL score were higher in the RAPN group than in the LPN group,and the difference was The difference was statistically significant(P<0.05).There were no postoperative complications in both groups,and the postoperative pathology returned 27 cases of renal clear cell carcinoma,2 cases of papillary renal cell carcinoma,4 cases of vascular smooth muscle lipoma,1 case of eosinophilic renal cell tumor,and 2 cases of cystic renal tumor,and the surgical margins were negative.Conclusion:(1)da Vinci robot-assisted retropubic partial nephrectomy can achieve the same tumor control effect as conventional retropubic partial nephrectomy,while reducing surgical bleeding,decreasing thermal ischemia time,enabling faster recovery of gastrointestinal function,shortening patients’ postoperative hospital stay,and ultimately reducing the probability of patients’ postoperative bleeding infection and other related complications.(2)The da Vinci robotic-assisted laparoscopic partial nephrectomy has higher safety and better perioperative outcomes than traditional laparoscopic partial nephrectomy,and the robotic surgical system can be the first choice for the treatment of renal tumors when combined with the economic conditions of patients’ families.