Abstract
ObjectiveTo explore the clinical outcomes and effect on intraoperative blood loss and postoperative pain of patients undergoing the retroperitoneal laparoscopic partial nephrectomy (RLPN) for complex renal tumors.MethodsFifty patients with complex renal tumor admitted to our hospital from February 2017 to February 2019 were selected as the research object and divided into the RLPN group (given the retroperitoneal laparoscopic partial nephrectomy, n = 24) and the OPN group (given the open partial nephrectomy, n = 26) by number table method to compare their various perioperative indicators and serum stress response and analyze the clinical effect of different surgical methods on the complex renal tumor.ResultsThe clinical information of patients in both groups were not significantly different (P > 0.05); in addition to the operative time, the intraoperative blood loss, hospital stay, warm ischemia time, and numerical rating scale (NRS) scores of the RLPN group were clearly lower than those of the OPN group (P < 0.05); after treatment, patients in the RLPN group obtained significantly lower white blood cell (WBC) count, cortisol, and c-reactive protein (CRP) levels than the OPN group (P < 0.05); the renal glomerular filtration rate (GFR) of the affected side, quality of life scores, and 3-year overall survival rate of treated patients in the RLPN group were obviously higher than those in the OPN group (P < 0.05); and patients in the RPLN group had significantly lower incidence rate (P < 0.05).ConclusionCompared with OPN, RLPN is more worthy of promotion and application, because it has better treatment outcomes, significantly reduces intraoperative blood loss, alleviates the body stress response and postoperative pain, and improves the quality of life.
Highlights
The renal tumor is a common type of urinary system tumors with the incidence rate that ranks only second to bladder cancer
General information Totally, 50 patients with complex renal tumor admitted to our hospital from February 2017 to February 2019 were selected as the research object and divided into the retroperitoneal laparoscopic partial nephrectomy (RLPN) group (n = 24) and the open partial nephrectomy (OPN) group (n = 26) by number table method
Inclusion criteria The inclusion criteria are as follows: (1) the patients were diagnosed as complex renal tumor by intravenous pyelogram and other imaging examinations; (2) no chemotherapy or other tumor related treatment was given before operation; (3) the renal function indexes such as serum creatinine and urea nitrogen were normal before operation; and (4) the study was approved by the Hospital Ethics Committee, and the patients have signed the informed consent
Summary
The renal tumor is a common type of urinary system tumors with the incidence rate that ranks only second to bladder cancer. Clinical studies have confirmed [3] that renal tumors are resistant to a variety of drugs and less sensitive to radiation, leading to limited biological targeting and immunotherapy, so surgical intervention becomes the most effective treatment modality for renal tumors. Nephron-sparing surgery (NSS), a type of surgery currently advocated in clinical treatment of renal tumors [4, 5], effectively preserves patients’ nephrons and prolongs patients’ survival time to some extent. We compared the clinical efficacy of RLPN with OPN in the treatment of complex renal tumors and analyzed the effect on intraoperative blood loss and postoperative pain in patients, as reported as follows
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