腫瘍径7cm以下の腎腫瘍に対するロボット支援腎部分切除術の検証

Abstract

The aim of this study was to compare the perioperative results of robot-assisted partial nephrectomy (RAPN) with those of laparoscopic partial nephrectomy (LPN) for cT1 renal tumors. From August 2015 to March 2018, 63 consecutive cases undergoing LPN and RAPN (30 cases of LPN and 33 cases of RAPN) for renal tumors ≤7cm in diameter (cTla: 42 cases and cT1b: 21 cases) were evaluated. The trifecta was defined on the basis of the following three criteria: ischemic time less than 25 minutes, no positive surgical margin, and no perioperative complications within four weeks postoperative. The background factors were compared between the two groups. There were no cases requiring changes in the operation methods. There was no significant difference in age, body mass index, gender, or tumor side between the two groups. While the mean tumor diameter and mean RENAL nephrometry score (RNS) were 32.6 mm and 7.3, respectively, there were no differences between the two groups. The warm ischemic time of RAPN was significantly shorter than that of LPN (12.7 min vs 19.9 min, P = 0.0007), and the estimated blood loss of RAPN was less than that of LPN (58.6 ml vs 160.3 ml, P = 0.0005). While there was no apparent tumor damage, tumor exposure on the resection surface was observed in two cases. Perioperative complications were observed in four cases. The trifecta achievement rate of RAPN and that of LPN was 93.9% (31 cases) and 66.7% (20 cases), respectively. The initial perioperative results of RAPN were comparable with those of LPN for cT1 renal tumors.