文章：

评估从三维腹腔镜到机器人辅助肾部分切除术的过渡：三联征达成率与肾肿瘤评分差异

Evaluating the Transition from 3D Laparoscopy to Robotic Partial Nephrectomy: Trifecta Achievement and Nephrometry Score Differences

原文发布日期：13 December 2025

DOI: 10.3390/cancers17243976

类型: Article

开放获取: 是

英文摘要：

Background: Partial nephrectomy (PN) is the standard treatment for localized renal tumors where nephron preservation is feasible. The evolution of minimally invasive surgery has progressed from conventional two-dimensional laparoscopy to three-dimensional (3D) laparoscopy and, more recently, to robotic-assisted techniques. Although robotic and laparoscopic PN have been widely compared, evidence focusing on a complete transition from 3D laparoscopy to robot-assisted partial nephrectomy (RAPN) remains scarce. Methods: This retrospective single-surgeon study included 80 consecutive patients treated between 2018 and 2024, encompassing the full transition period from 3D LPN to RAPN. Thirty-six patients underwent 3D laparoscopy and forty-four underwent robotic surgery, excluding the first ten robotic cases representing the learning phase. Propensity score weighting was applied to minimize baseline differences. Results: Tumors treated with RAPN had significantly higher RENAL scores (median 8 vs. 6,p= 0.001), indicating greater complexity, while perioperative outcomes—including hospital stay, operative time, and complication rates—remained comparable. Warm ischemia time was significantly shorter in the RAPN group (17.5 vs. 22 min,p= 0.005), and the TRIFECTA rate was higher though not statistically significant. Conclusions: These results indicate that a complete transition from 3D laparoscopy to robotic partial nephrectomy is safe and feasible, maintaining or improving outcomes even in more complex tumors and broadening the applicability of nephron-sparing surgery.

摘要翻译： 

背景：对于可行肾单位保留的局限性肾肿瘤，部分肾切除术（PN）是标准治疗方法。微创手术的发展已从传统的二维腹腔镜手术演进至三维（3D）腹腔镜手术，并进一步发展到机器人辅助技术。尽管机器人辅助与腹腔镜部分肾切除术已被广泛比较，但聚焦于从3D腹腔镜完全过渡至机器人辅助部分肾切除术（RAPN）的证据仍较为有限。 方法：本回顾性单外科医生研究纳入2018年至2024年间连续治疗的80例患者，覆盖了从3D腹腔镜部分肾切除术（3D LPN）到RAPN的完整过渡期。其中36例患者接受3D腹腔镜手术，44例接受机器人手术，并排除了代表学习阶段的最初10例机器人手术病例。研究采用倾向评分加权法以最小化基线差异。 结果：RAPN组治疗的肿瘤RENAL评分显著更高（中位数8分 vs. 6分，p=0.001），表明肿瘤复杂性更高，但围手术期结果——包括住院时间、手术时间和并发症发生率——保持相当。RAPN组的温缺血时间显著缩短（17.5分钟 vs. 22分钟，p=0.005），TRIFECTA达标率更高，但未达到统计学显著性。 结论：这些结果表明，从3D腹腔镜完全过渡至机器人部分肾切除术是安全可行的，即使在更复杂的肿瘤中也能维持或改善手术效果，从而拓宽了肾单位保留手术的适用范围。

原文链接：

Evaluating the Transition from 3D Laparoscopy to Robotic Partial Nephrectomy: Trifecta Achievement and Nephrometry Score Differences