机器人辅助和普通腹腔镜肾部分切除术治疗肾血管平滑肌脂肪瘤的比较

目的对比肾血管平滑肌脂肪瘤（RAML）患者中应用机器人辅助肾部分切除术（RAPN）与普通腹腔镜下肾部分切除术（LPN）的安全性及有效性。 方法收集2016年1月至2021年8月我院收治的肾血管平滑肌脂肪瘤患者198例，其中80例为机器人辅助肾部分切除术组，118例为腹腔镜下肾部分切除术组。采用倾向性评分匹配后分析比较两术式的临床指标。 结果198例患者中有3例术中中转开放（包括2例LPN，1例RAPN），1例LPN术中损伤输尿管，其余均顺利完成手术。RAPN组术中热缺血时间显著低于LPN组；RAPN组术后血红蛋白（Hb）差值百分比及eGFR差值百分比均显著低于LPN组（P<0.05）；手术时间、术中估计出血量、术中及术后输血率、术后并发症、术后引流量、引流管留置时间、胃肠道功能恢复时间、术后住院时间方面两组差异无统计学意义。 结论在肾血管平滑肌脂肪瘤患者中，应用机器人辅助肾部分切除术相较于普通腹腔镜下肾部分切除术具有显著优势，手术出血更少，热缺血时间更短，能更大程度保留肾功能。

Comparison of robotic-assisted laparoscopic partial nephrectomy versus laparoscopic partial nephrectomy for the treatment of renal angiomyolipoma

ObjectiveTo compare the safety and efficacy of robot assisted partial nephrectomy (RAPN) and laparoscopic partial nephrectomy (LPN) in treatment of patients with renal angiomyolipoma (RAML). Methods198 patients diagnosed with renal angiomyolipoma admitted to our hospital from January 2016 to August 2021 were collected, including 80 in the robot assisted partial nephrectomy group and 118 in the laparoscopic partial nephrectomy group. After propensity score matching, the clinical data were analyzed and compared between the two groups. ResultsAmong 198 cases, 3 cases were converted to open partial nephrectomy (including 2 cases of LPN and 1 case of RAPN), 1 case of LPN injured ureter during operation, and the rest were successfully completed. The warm ischemia time in RAPN group was significantly less than that in LPN group. The percentage of postoperative Hb loss and eGFR loss in RAPN group were significantly lower than those in LPN group (P<0.05). There was no significant difference between the two groups in operation time, estimated blood loss, intraoperative and postoperative blood transfusion rate, postoperative complications rate, postoperative drainage volume, catheterization time, gastrointestinal functional recovery time and length of postoperative hospital stay. ConclusionCompared with LPN, RAPN has significant advantages in treating patients with renal angiomyolipoma in terms of less blood loss, shorter warm ischemia time and greater preservation of renal function.