Oncologic Outcomes and Safety Assessment of Retroperitoneal Laparoscopic Partial Nephrectomy versus Open Partial Nephrectomy in Treating Patients with Localized Renal Cell Carcinoma: A Propensity Score Matching Study.

IF 0.9 4区 医学 Q3 SURGERY Annali italiani di chirurgia Pub Date : 2024-01-01 DOI:10.62713/aic.3520
Yamin Chu, Pei Jin, Nuan Xu, Xiaoyan Mu
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Abstract

Aim: Surgical intervention is crucial in radical resection of renal cell carcinoma (RCC). Different surgical procedures have different oncologic outcomes and safety in patients with RCC. Therefore, we aimed to investigate the oncologic outcomes and safety of retroperitoneal laparoscopic partial nephrectomy (RLPN) versus open partial nephrectomy (OPN) in treating patients with localized RCC.

Methods: This retrospective cohort study included 160 patients with localized RCC who underwent either OPN or RLPN from January 2016 to June 2020. Out of these patients, 75 patients were treated with OPN and 85 patients were treated with RLPN. After propensity score matching, 130 patients (65 cases in each group) were finally included in the analysis. Additionally, surgical outcomes, three-year survival rates, and renal function parameters were assessed between the two groups, and the data were statistically analyzed using SPSS.

Results: Compared to the OPN group, RLPN demonstrated significantly shorter surgical time, lower estimated blood loss (p < 0.05), and lower incidence of complications (p = 0.024). In contrast, the RLPN group had significantly longer warm ischemia time (p = 0.011) than the OPN group. Furthermore, there were no significant differences in three-year overall survival, disease-free survival, cancer specific survival rates, positive surgical margins, hospitalization time between the RLPN and OPN groups (p > 0.05). The incidence of complications in the RLPN group was significantly lower than that in the OPN group (p = 0.024). Postoperatively, creatinine level was significantly lower following RLPN at one year compared to OPN (p = 0.029).

Conclusions: RLPN offers advantages in surgical time, estimated blood loss, and postoperative complications, and it positively affects postoperative renal function, while OPN shows a shorter warm ischemia time. These two approaches result in comparable three-year survival rates. This study provides valuable insights into the oncologic outcomes and safety of RLPN compared to OPN in treating localized RCC.

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腹膜后腹腔镜肾部分切除术与开放式肾部分切除术治疗局部肾细胞癌患者的肿瘤结果和安全性评估:倾向得分匹配研究。
目的:手术干预对于根治性切除肾细胞癌(RCC)至关重要。不同的手术方法对 RCC 患者有不同的肿瘤治疗效果和安全性。因此,我们旨在研究腹膜后腹腔镜肾部分切除术(RLPN)与开放性肾部分切除术(OPN)在治疗局部RCC患者中的肿瘤治疗效果和安全性:这项回顾性队列研究纳入了2016年1月至2020年6月期间接受OPN或RLPN手术的160例局部RCC患者。其中,75 名患者接受了 OPN 治疗,85 名患者接受了 RLPN 治疗。经过倾向得分匹配,最终有130名患者(每组65例)被纳入分析。此外,还对两组患者的手术效果、三年生存率和肾功能参数进行了评估,并使用 SPSS 对数据进行了统计分析:与 OPN 组相比,RLPN 组的手术时间明显更短、估计失血量更低(P < 0.05)、并发症发生率更低(P = 0.024)。相比之下,RLPN 组的温热缺血时间(p = 0.011)明显长于 OPN 组。此外,RLPN 组和 OPN 组的三年总生存率、无病生存率、癌症特异生存率、手术切缘阳性率和住院时间均无明显差异(p > 0.05)。RLPN 组的并发症发生率明显低于 OPN 组(P = 0.024)。术后一年,RLPN 组的肌酐水平明显低于 OPN 组(p = 0.029):结论:RLPN 在手术时间、估计失血量和术后并发症方面具有优势,对术后肾功能有积极影响,而 OPN 的热缺血时间更短。这两种方法的三年生存率相当。这项研究为我们提供了有价值的见解,让我们了解在治疗局部 RCC 时,RLPN 与 OPN 相比的肿瘤治疗效果和安全性。
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来源期刊
CiteScore
0.90
自引率
12.50%
发文量
116
审稿时长
>12 weeks
期刊介绍: Annali Italiani di Chirurgia is a bimonthly journal and covers all aspects of surgery:elective, emergency and experimental surgery, as well as problems involving technology, teaching, organization and forensic medicine. The articles are published in Italian or English, though English is preferred because it facilitates the international diffusion of the journal (v.Guidelines for Authors and Norme per gli Autori). The articles published are divided into three main sections:editorials, original articles, and case reports and innovations.
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