Efficacy analysis of robot-assisted radical nephroureterectomy and laparoscopic radical nephroureterectomy for non-metastatic high-risk upper tract urothelial carcinoma

Abstract:

Objective：To investigate the clinical efficacy of robot-assisted radical nephroureterectomy（RRNU） for patients with non-metastatic high-risk upper tract urothelial carcinoma（UTUC） compared with laparoscopic nephroureterectomy（LRNU）. Methods：We retrospectively analyzed 70 cases of non-metastatic high-risk UTUC treated by radical nephroureterectomy from January 2018 to December 2020，including 19 cases of RRNU and 51 cases of LRNU. The perioperative outcomes and oncology prognosis were ana－lyzed. Results：There was no death caused by major vascular injury and other serious complications. There were no significant differ－ences in recurrence between the two groups（P >0.05）. There were statistically significant differences in postoperative hospital stay（d）[5（4，6） vs. 6（5，8），Z=2.076，P=0.038]，postoperative drainage volume（mL）[75（20，186） vs. 160（90，245），Z=2.411，P=0.016]，drainage tube retention time（d）[2（3，4） vs. 3（4，5），Z=2.276，P=0.023] and cost（ten thousand yuan）[8.33（7.51，8.78）vs. 3.91（3.46，4.94），Z=6.319，P=0.000]. There were no significant differences in intraoperative blood loss and operation time（P >0.05）. Conclusion：There are no significant differences in recurrence between RRNU and LRNU in the treatment of non-metastatic high-risk UTUC. RRNU has the advantages of shortening postoperative hospital stay，reducing postoperative drainage and drainage tube retention time，and accelerating the recovery of patients，but the cost of RRNU is more expensive.