Comparative Study On Efficacy Of Robotic-assisted Laparoscopic Transperitoneal Partial Nephrectomy And Laparoscopic Retroperitoneal Partial Nephrectomy For Localized Renal Tumors

Objectives: To compare the difference between the transabdominal approach robotic-assisted laparoscopic partial nephrectomy(RALPN)and retroperitoneal approach with traditional laparoscopic partial nephrectomy(LPN)for the treatment of localized renal tumors.Methods: Collect 165 Patients with renal cell carcinoma to undergo partial nephrectomy from June 2016 to January 2018 in the Urology Department of Jiangsu Provincial People's Hospital,including 76 cases in the RALPN group and 89 cases in the LPN group.The preoperative basic data,intraoperative data,perioperative complications,postoperative recovery,oncological treatment effects,renal function changes,and follow-up data were collected and compared between the two groups.Results: Both RALPN and LPN operations were performed,except for one patient in the LPN group who underwent radical nephrectomy.Preoperative data for age,gender,charlson comorbidity index,American Anesthesiologists Association score(ASA score),RENAL score,tumor size,side,preoperative hemoglobin and preoperative estimated glomerular filtration rate(eGFR)were not statistically significant Difference(P>0.05),Body mass index(BMI)was significantly different(P<0.05).There were statistical differences(P<0.05)in operative time,warm ischemia time,intraoperative blood loss,and intraoperative collection system injury between the two groups of data.In addition to the operation time,all indicators of the RALPN group were superior to the LPN group.For postoperative 24 h blood loss,the RALPN group was less than the LPN group,and the recovery time of gastrointestinal function was longer in the RALPN group than in the LPN group.There was a statistical difference.The Perioperative blood transfusion rate,drainage tube removal time,postoperative hospital stay,percentage of postoperative eGFR reduction,and perioperative complications were not statistically different.The pathological margins of the two groups were negative,and they all achieved satisfactory oncological treatment.During the follow-up period,1 case of renal tumor recurrence occurred in the RALPN group,1 case of recurrence in the LPN group,and 1 case of undetected new lesions in the lung.Conclusion: Transabdominal robot assisted partial nephrectomy has advantages in terms of warm ischemia time,intraoperative blood loss,intraoperative systemic injury,and postoperative 24-hour drainage,expect intraoperative and postoperative complications and postoperative eGFR.Percentage decline of eGFR and thelong-term follow-up did not show significant differences.