Abstract：
Objective: To compare the safety and effectiveness of robot-assisted partial nephrectomy (RAPN) vs laparoscopic partial nephrectomy (LPN) in the treatment of central renal angiomyolipomas (AMLs). Methods: We retrospectively analyzed the clinical data of 103 patients who were treated with either RAPN or LPN for central AMLs between January 2017 and June 2022. Propensity scores were matched according to sex, age, laterality, body mass index, symptoms, diameter of tumor, location of tumor distribution, R.E.N.A.L score, preoperative hemoglobin, preoperative serum creatinine, preoperative estimated glomerular filtration rate, chronic disease, previous abdominal surgery, preoperative selective arterial embolization, American Society of Anesthesiologists scale, and duration of follow-up, and after matching, perioperative and prognostic data of the two groups were compared. Results: A total of 57 patients underwent RAPN, and 46 patients underwent LPN. Before matching, there were more complex AMLs in the RAPN group, and R.E.N.A.L scores differed between the two groups (10 vs 9, p < 0.001). After matching, the median warm ischemic time in the RAPN group was significantly shorter than that in the LPN group (21.5 minutes vs 28 minutes, p = 0.034), as well as the median time of postoperative mobilization (1 day vs 2 days, p < 0.001). The other indicators were not significantly different between the groups. Conclusions: For central AMLs, both RAPN and LPN were safe and feasible surgical treatments, but RAPN might be associated with shorter warm ischemia time and earlier postoperative mobilization.
摘要：
目的：比较机器人辅助肾部分切除术（RAPN）与腹腔镜肾部分切除术（LPN）治疗中央型肾血管平滑肌脂肪瘤（AMLs）的安全性和有效性。
方法：我们回顾性分析了在2017年1月至2022年6月期间接受RAPN或LPN治疗的103例患者的临床资料。倾向得分按性别匹配，年龄,偏侧性,BMI,症状,肿瘤直径,肿瘤分布的位置，R.E.N.A.L得分,术前血红蛋白,术前血清肌酐,术前eGFR,慢性疾病,以前的腹部手术，术前SAE,ASA量表,和随访持续时间，匹配后，比较两组患者围手术期及预后情况。
结果：共有57例患者接受了RAPN，46例患者行LPN。匹配之前,RAPN组有更复杂的AMLs,R.E.N.A.两组之间的L评分不同（10对9，P<0.001）。匹配后,RPN组的中位热缺血时间（WIT）明显短于LPN组（21.5min对28min，P=0.034),RPN组的中位下床时间明显短于LPN组（1天比2天，P<0.001)。其他指标组间差异无统计学意义。
结论：RAPN对中央型肾血管平滑肌脂肪瘤具有较短的热缺血时间和下床时间。应用两种手术方法治疗中央型肾血管平滑肌脂肪瘤是安全可行的。
方法：我们回顾性分析了在2017年1月至2022年6月期间接受RAPN或LPN治疗的103例患者的临床资料。倾向得分按性别匹配，年龄,偏侧性,BMI,症状,肿瘤直径,肿瘤分布的位置，R.E.N.A.L得分,术前血红蛋白,术前血清肌酐,术前eGFR,慢性疾病,以前的腹部手术，术前SAE,ASA量表,和随访持续时间，匹配后，比较两组患者围手术期及预后情况。
结果：共有57例患者接受了RAPN，46例患者行LPN。匹配之前,RAPN组有更复杂的AMLs,R.E.N.A.两组之间的L评分不同（10对9，P<0.001）。匹配后,RPN组的中位热缺血时间（WIT）明显短于LPN组（21.5min对28min，P=0.034),RPN组的中位下床时间明显短于LPN组（1天比2天，P<0.001)。其他指标组间差异无统计学意义。
结论：RAPN对中央型肾血管平滑肌脂肪瘤具有较短的热缺血时间和下床时间。应用两种手术方法治疗中央型肾血管平滑肌脂肪瘤是安全可行的。
