经腹腔入路与腹膜后入路机器人辅助肾部分切除术治疗肾背侧肿瘤的围手术期指标比较

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ABSTRACT：ObjectiveTo compare peritoneal indexes between transperitoneal approach and retroperitioneal approach of robot-assisted partial nephrectomy （RAPN） for dorsal renal tumors via transperitoneal and retroperitoneal approaches，thereby providing reference for clinical decision-making in managing such neoplasms.MethodsThe clinical data of renal cancer patients undergoing RAPN performed by the same surgeon at our hospital during 2017 and 2021 were retrospectively analyzed.A total of 80 patients with complete data of dorsal renal tumors were screened and divided into two groups based on the surgical approaches：50 cases in the transperitoneal group and 30 in the retroperitoneal group.The general information，intraoperative data，positive rate of pathological margins，recovery time of gastrointestinal functions，and incidence of complications were compared between the two groups.ResultsAll operations were successfully completed， and the surgical margins were negative.There were no statistically significant differences in warm ischemia time [17 （15，18） min vs.16 （14，19） min，P=0.772]，operation time [120 （105，149） min vs.124 （108，152） min，P=0.584]，intraoperative blood loss [100 （50，100） mL vs.100 （50，100） mL，P=0.814]，and incidence of postoperative complications （17% vs.24%，P=0.504） between the two groups （P>0.05）.The postoperative recovery time of gastrointestinal functions in the retroperitoneal group was significantly shorter than that in the transperitoneal group [2.0 （2.0，3.0） d vs.3.5 （3.0，4.0） d，P<0.001].ConclusionThe perioperative outcomes of patients undergoing RAPN via the retroperitoneal approach are similar to those via the transperitoneal approach.However，the retroperitoneal approach has an advantage of faster recovery of gastrointestinal functions.

摘要：目的比较经腹腔入路与腹膜后入路机器人辅助肾部分切除术（RAPN）治疗肾背侧肿瘤（R.E.N.A.L.评分为P）的围手术期指标，为该类肿瘤的临床决策提供参考。（剩余7917字）