機器人手臂與傳統手術對高複雜度腎臟腫瘤處理之預後比較
陳嘉宏1、鐘孝仁1,2,3、張延驊1,2,3林登龍1,2,3、陳光國1,2,3
台北榮民總醫院泌尿部1; 陽明大學醫學系泌尿學科 2; 書田泌尿科學研究中心3
A comparison of outcomes between robotic and open partial nephrectomy for high complex renal cell carcinoma
Chia-Hung Chen1, Hsiao-Jen Chung 1,2,3, Yen-Hua Chang1,2,3,
Alex Tong-Long Lin1,2,3, Kuang-Kuo Chen1,2,3
Department of Urology, Taipei Veterans General Hospital, Taipei , Taiwan 1; Department of Urology, School of Medicine, National Yang-Ming University, Taipei, Taiwan 2; Shu-Tien Urological Science Research Center , Taipei, Taiwan3
Purpose:
To compare the surgical, functional and oncological outcomes of patients undergoing robotic partial nephrectomy (RPN) or open partial nephrectomy (OPN) for highly complex renal cell carcinoma (RENAL nephrometry score ≥10).
Materials and Methods:
From 2010 to 2015, there are 65 patients who treated by partial nephrectomy for complex renal cell carcinoma (RENAL nephrometry score ≥10) in Taipei Veteran General Hospital. They underwent open partial nephrectomy (OPN, n=48) , and robotic partial nephrectomy (RPN, n=17) We retrospectively analyzed their demographic data, perioperative, functional and oncological outcomes.
Results:
Among 65 patients, 46 are males and 19 females. The mean age of the patients was 50.0± 12.6 (range 26-83). Both OPN group and RaPN had similar demographic characteristics (Table 1). There are no difference between operative time (291.0 vs. 292.0; p=0.99), blood loss (371.4 vs. 399.4; p =0.82), hospitalization (5.6 vs. 5.9 day; p =0.47), and postoperative surgical complications (35.3 vs. 39.1%; p=0.87), Clavien 3–4 surgical complications (14.6 vs. 5.9%; p =0.35) (Table 2). No patient had positive margin after surgery (Table 3). Change of pre-operative and post-operative creatinine on 6 months and 12 months was also no difference (0.12 vs. 0.09; p =0.59) (0.13 vs.0.11; p =0.78) (Table 4).
Conclusion:
There are no difference on demographic data, perioperative, functional and oncological outcomes between OPN and RaPN. Both are effective treatment for complex renal tumor.