腎細胞癌患者接受開腹與機械手臂輔助部分腎切除手術的預後差異
樊樂威、張英勛、馮思中
林口長庚紀念醫院 外科部 泌尿科
The comparison of outcomes of robot-assisted and open partial nephrectomy in renal cell carcinoma: A single center experience
Le-Wei Fan, Ying-Hsu Chang, See-Tong Pang
Divisions of Urology, Department of Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
Purpose: We compare the pros and cons between open and robotic partial nephrectomy for renal cell carcinoma (RCC) during the past nine years in Chang Gung Memorial Hospital (CGMH).
Materials and Methods: We retrospectively reviewed the charts of RCC patients from January 2007 to December 2015 in CGMH, Linkou branch. A total of 155 patients with localized RCC who underwent open partial nephrectomy (OPN) or robotic partial nephrectomy (RPN) were included. We analyzed the data to evaluate the clinical and oncological outcomes of these two surgical methods for patients with localized RCC in our hospital.
Results: There were 75 OPN and 80 RPN patients, respectively. Patients who underwent OPN were older (p = 0.033) and had lower pre-operative estimated glomerular filtration rate (p = 0.001) than patients who underwent RPN. These two groups were similar to pre-operative tumor complexity (Nephrometry) and final pathological stage. RPN had a significantly longer operative time (p < 0.001) but which showed less immediate decrement of eGFR (p = 0.034) and hospital stay (p = 0.046). No differences existed in the margin status, the long-term change of eGFR, transfusion rate, decrement of hemoglobin, complication and recurrence rate between the two groups.
Conclusions: RPN offered a short-term less decrease in post-operative renal function and shorter length of hospital stay than OPN, with comparable oncological outcomes.