Efficacy of robot-assisted partial nephrectomy compared to conventional laparoscopic partial nephrectomy for completely endophytic renal tumor: a multicenter, prospective study

被引：2

作者：

Hinata, Nobuyuki ^{[1
,2
]}

Murakami, Sae ^{[3
]}

Nakano, Yuzo ^{[2
]}

Hara, Isao ^{[4
]}

Kondo, Tsunenori ^{[5
]}

Hamamoto, Shuzo ^{[6
]}

Shiroki, Ryoichi ^{[7
]}

Nagayama, Jun ^{[8
]}

Kawakita, Mutsushi ^{[9
]}

Eto, Masatoshi ^{[10
]}

Ukimura, Osamu ^{[11
]}

Takenaka, Atsushi ^{[12
]}

Takagi, Toshio ^{[13
]}

Shimbo, Masaki ^{[14
]}

Azuma, Haruhito ^{[15
]}

Yoshida, Tetsuya ^{[16
]}

Furukawa, Junya ^{[17
]}

Kawamorita, Naoki ^{[18
]}

Fujisawa, Masato ^{[2
]}

机构：

[1] Hiroshima Univ, Grad Sch Biomed & Hlth Sci, Dept Urol, 1-2-3 Kasumi Minami Ku, Hiroshima 7348551, Japan

[2] Kobe Univ, Grad Sch Med, Dept Urol, Kusunoki Cho,Chuo Ku, Kobe, Hyogo 6570017, Japan

[3] Kobe Univ Hosp, Clin & Translat Res Ctr, Kusunoki Cho,Chuo Ku, Kobe, Hyogo 6500017, Japan

[4] Wakayama Med Univ, Dept Urol, 811-1 Kimiidera, Wakayama 6418509, Japan

[5] Tokyo Womens Med Univ, Adachi Med Ctr, Dept Urol, 4-33-1 Kohoku,Adachi Ku, Tokyo 1238558, Japan

[6] Nagoya City Univ, Dept Nephrourol, 1 Kawasumi Mizuho Cho,Mizuho Ku, Nagoya, Aichi 4678602, Japan

[7] Fujita Hlth Univ, Dept Urol, Sch Med, 1-98 Dengakugakubo,Kutsukake Cho, Toyoake, Aichi, Japan

[8] Nagoya Univ, Grad Sch Med, Dept Urol, 65 Tsurumai Cho,Showa Ku, Nagoya, Aichi 4668560, Japan

[9] Kobe City Med Ctr Gen Hosp, Dept Urol, 2-1-1 Minatojima Minamimachi,Chuo Ku, Kobe, Hyogo 6500047, Japan

[10] Kyushu Univ, Dept Urol, 744 Motooka Nishi Ku, Fukuoka, Fukuoka 8190395, Japan

[11] Kyoto Prefectural Univ Med, Grad Sch Med Sci, Dept Urol, 465 Kajiicho,Kawaramachi Hirokoji,Kamigyo Ku, Kyoto, Kyoto 6028566, Japan

[12] Tottori Univ, Fac Med, Grad Sch Med, Dept Surg,Div Urol, 36-1 Nishicho, Yonago, Tottori 6838504, Japan

[13] Tokyo Womens Med Univ Hosp, Dept Urol, 8-1 Kawadacho,Shinjuku Ku, Tokyo 1628666, Japan

[14] St Lukes Int Hosp, Dept Urol, 9-1 Akashicho,Chuo Ku, Tokyo 1040044, Japan

[15] Osaka Med & Pharmaceut Univ Hosp, Dept Urol, 2-7 Daigakumachi, Takatsuki, Osaka 5698686, Japan

[16] Shiga Univ Med Sci Hosp, Dept Urol, Otsu, Shiga 5202192, Japan

[17] Tokushima Univ, Grad Sch Biomed Sci, Dept Urol, 3-18-15 Kuramoto Cho, Tokushima, Tokushima 7708503, Japan

[18] Tohoku Univ, Dept Urol, Grad Sch Med, Seiryomachi,Aoba Ku, Sendai, Miyagi 9808574, Japan

来源：

INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY | 2024年 / 29卷 / 10期

关键词：

Nephrectomy; Robotic surgical procedures; Carcinoma; Renal cell; Renal insufficiency;

D O I：

10.1007/s10147-024-02599-9

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background This study aimed to compare the efficacy of robot-assisted partial nephrectomy for completely endophytic renal tumors with the reported outcomes of conventional laparoscopic partial nephrectomy and investigate the transition of renal function after robot-assisted partial nephrectomy. Methods We conducted a prospective, multicenter, single-arm, open-label trial across 17 academic centers in Japan. Patients with endophytic renal tumors classified as cT1, cN0, cM0 were included and underwent robot-assisted partial nephrectomy. We defined two primary outcomes to assess functional and oncological aspects of the procedure, which were represented by the warm ischemic time and positive surgical margin, respectively. Comparisons were made using control values previously reported in laparoscopic partial nephrectomy studies. In the historical control group, the warm ischemia time was 25.2, and the positive surgical margin was 13%. Results Our per-protocol analysis included 98 participants. The mean warm ischemic time was 20.3 min (99% confidence interval 18.3-22.3; p < 0.0001 vs. 25.2). None of the 98 participants had a positive surgical margin (99% confidence interval 0-5.3%; p < 0.0001 vs. 13.0%). The renal function ratio of eGFR before and after protocol treatment multiplied by splits was 0.70 (95% confidence interval: 0.66-0.75). Factors such as preoperative eGFR, resected weight, and warm ischemic time influenced the functional loss of the partially nephrectomized kidney after robot-assisted partial nephrectomy. Conclusions Robot-assisted partial nephrectomy for completely endophytic renal tumors offers a shorter warm ischemia time and comparable positive surgical margin rate compared with conventional laparoscopic partial nephrectomy.

引用

页码：1548 / 1556

页数：9

共 30 条

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