Comparison of robotic-assisted and laparoscopic partial nephrectomy based on the PADUA score and the predictive value of the PADUA score and the Mayo Adhesive Probability score for postoperative complications: a single-center retrospective study.

IF 2.7 3区医学 Q3 ONCOLOGY Journal of Cancer Research and Clinical Oncology Pub Date : 2024-12-04 DOI:10.1007/s00432-024-06037-1

Shuo Liu, Bowen Zhang, Bowen Weng, Xiangqiang Liu, Sichuan Hou

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Abstract

Purpose: This study compared perioperative outcomes of robot-assisted partial nephrectomy (RAPN) and laparoscopic partial nephrectomy (LPN) through the PADUA score as well as assessed the predictive value of the PADUA score and the Mayo Adhesive Probability (MAP) score for postoperative complications.

Methods: Totally 196 patients suffering from RAPN or LPN for renal tumors were reviewed retrospectively. Patients were categorized by PADUA score (low-, moderate-, high-complexity) and MAP score (low-, intermediate-, high-grade). Evaluated outcomes included operative time (OT), warm ischemia time (WIT), estimated blood loss (EBL), drainage duration, postoperative length of stay, and absolute change in estimated glomerular filtration rate (eGFR) at three months post-surgery, along with intra- and postoperative complications.

Results: RAPN outperformed LPN in the low-complexity group by lowering WIT (P = 0.022) and absolute eGFR change (P = 0.011). For moderate-complexity group, RAPN reduced WIT (P = 0.021), absolute eGFR change (P = 0.027), and postoperative length of stay (P = 0.008). In the high-complexity group, RAPN reduced OT (P = 0.015), WIT (P = 0.023), EBL (P = 0.036), absolute eGFR change (P = 0.024), and postoperative length of stay (P = 0.019). Drainage duration showed no significant differences across groups (P = 0.442, P = 0.327, P = 0.260). RAPN incurred significantly higher total costs than LPN across groups (P < 0.001). ROC analysis suggested PADUA and MAP scores as reliable predictors of postoperative complications in RAPN (AUC = 0.880,0.828) and LPN (AUC = 0.757,0.702).

Conclusion: RAPN provides significant advantages over LPN in managing complex renal tumors (PADUA score ≥ 10), significantly in reducing OT, WIT, EBL, and absolute eGFR change at three months post-surgery, while minimizing postoperative stay. The PADUA and MAP scores are valuable in predicting postoperative complication.

Trial registration number and date of registration: Retrospectively registered.

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基于PADUA评分的机器人辅助和腹腔镜部分肾切除术的比较以及PADUA评分和Mayo粘连概率评分对术后并发症的预测价值：一项单中心回顾性研究。

目的：本研究通过PADUA评分比较机器人辅助部分肾切除术（RAPN）和腹腔镜部分肾切除术（LPN）围手术期预后，并评估PADUA评分和Mayo粘连概率（MAP）评分对术后并发症的预测价值。方法：对196例因肾肿瘤行RAPN或LPN的患者进行回顾性分析。根据PADUA评分（低、中、高复杂性）和MAP评分（低、中、高复杂性）对患者进行分类。评估结果包括手术时间（OT）、热缺血时间（WIT）、估计失血量（EBL）、引流时间、术后住院时间、术后3个月估计肾小球滤过率（eGFR）的绝对变化，以及手术内和术后并发症。结果：低复杂性组RAPN在降低WIT （P = 0.022）和eGFR绝对变化（P = 0.011）方面优于LPN。对于中度并发症组，RAPN降低了WIT （P = 0.021）、eGFR绝对变化（P = 0.027）和术后住院时间（P = 0.008）。在高复杂性组，RAPN降低了OT （P = 0.015）、WIT （P = 0.023）、EBL （P = 0.036）、eGFR绝对变化（P = 0.024）和术后住院时间（P = 0.019）。引流时间各组间差异无统计学意义（P = 0.442, P = 0.327, P = 0.260）。结论：RAPN在治疗复杂肾肿瘤（PADUA评分≥10）方面比LPN具有显著优势，在术后3个月显著降低OT、WIT、EBL和eGFR绝对变化，同时最大限度地减少术后住院时间。PADUA和MAP评分对预测术后并发症有价值。试验注册编号和注册日期：回顾性注册。

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来源期刊

Journal of Cancer Research and Clinical Oncology 医学-肿瘤学

CiteScore

4.00

自引率

2.80%

发文量

577

审稿时长

2 months

期刊介绍： The "Journal of Cancer Research and Clinical Oncology" publishes significant and up-to-date articles within the fields of experimental and clinical oncology. The journal, which is chiefly devoted to Original papers, also includes Reviews as well as Editorials and Guest editorials on current, controversial topics. The section Letters to the editors provides a forum for a rapid exchange of comments and information concerning previously published papers and topics of current interest. Meeting reports provide current information on the latest results presented at important congresses. The following fields are covered: carcinogenesis - etiology, mechanisms; molecular biology; recent developments in tumor therapy; general diagnosis; laboratory diagnosis; diagnostic and experimental pathology; oncologic surgery; and epidemiology.