Abstract：
This study aimed to evaluate and compare the perioperative outcomes of robot-assisted adrenalectomy (RAA) and laparoscopic adrenalectomy (LA) using propensity score matching. This retrospective study included 395 patients who underwent minimally invasive adrenalectomy: 354 who underwent LA and 41 who underwent RAA between February 2015 and March 2023. To mitigate potential confounding factors, 2:1 propensity score matching was conducted based on age, sex, body mass index, American Society of Anesthesiologists score, tumor laterality, and tumor size. Perioperative outcomes and complications were compared between the two groups, and prognostic factors for complications were analyzed. Propensity score matching analysis identified 123 patients, with 82 and 41 in the LA and RAA groups, respectively. Operative time (81.4 ± 26.6 min vs. 83.5 ± 25.9 min, P = 0.675), estimated blood loss (77.7 ± 68.3 mL vs. 83.2 ± 73.9 mL, P = 0.683), and post-operative stay (3.8 ± 1.0 days vs. 4.0 ± 0.9 days, P = 0.211) showed no significant differences between two groups. Intraoperative complications occurred in 8 patients (9.8%) in the LA group, while no patients (0%) experienced intraoperative complications in the RAA group (P = 0.051). In both groups, post-operative complications occurred in 2.4% (P = 1). The only factor contributing to complications after adrenalectomy was tumor size (OR 1.026, 95% CI 1.001-1.051, P = 0.042). RAA exhibited comparable perioperative outcomes and presented an improved intraoperative complication rate compared with LA. Tumor size was the only factor that contributed to complications after adrenalectomy.
摘要：
本研究旨在使用倾向评分匹配评估和比较机器人辅助肾上腺切除术（RAA）和腹腔镜肾上腺切除术（LA）的围手术期结果。这项回顾性研究包括395例接受微创肾上腺切除术的患者：在2015年2月至2023年3月期间接受LA的354例和接受RAA的41例。为了减轻潜在的混杂因素，根据年龄进行2：1倾向评分匹配，性别,身体质量指数,美国麻醉医师协会评分，肿瘤侧向性，和肿瘤大小。比较两组患者围手术期疗效及并发症,并对并发症的预后因素进行分析。倾向评分匹配分析确定123例患者，LA和RAA组中有82和41，分别。手术时间(81.4±26.6minvs.83.5±25.9分钟，P=0.675),估计失血量（77.7±68.3mL与83.2±73.9毫升，P=0.683),和术后住院时间(3.8±1.0天vs.4.0±0.9天,P=0.211）显示两组之间没有显着差异。LA组术中并发症8例(9.8%),而RAA组无患者（0%）出现术中并发症（P=0.051）。在这两组中,术后并发症发生率为2.4%(P=1)。肾上腺切除术后并发症的唯一因素是肿瘤大小（OR1.026，95％CI1.001-1.051，P=0.042）。与LA相比，RAA显示出相当的围手术期结果，并且术中并发症发生率提高。肿瘤大小是导致肾上腺切除术后并发症的唯一因素。
