Comparisons of Efficiency, Safety, and Hospital Costs of Four-Arm Robotic-Assisted Partial Nephrectomy (RAPN) Versus Three-Arm Technique: A Propensity Score–Matched Analysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Surgical Technique
2.3. Outcomes Measured and Statistical Analysis
3. Results
3.1. Demographics and Tumor Characteristics
3.2. Operative Outcomes and Hospital Costs
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
RCC | renal cell carcinoma |
RAPN | Robotic-assisted partial nephrectomy |
CNY | Chinese Yuan |
PN | partial nephrectomy |
IVC | inferior vena cava |
BMI | body mass index |
IQR | inter-quartile range |
WHO | World Health Organization |
SD | standard deviation |
SIRS | systemic inflammatory response syndrome |
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Before Propensity Score Maching | After Propensity Score Maching | |||||
---|---|---|---|---|---|---|
Variables | 3-Arm Group (n = 50) | 4-Arm Group (n = 41) | p | 3-Arm Group (n = 38) | 4-Arm Group (n = 38) | p |
Age (years), median (IQR) | 56.0 (49.8, 60.3) | 56.0 (48.0, 63.0) | 0.838 | 56.5 (49.3, 65.0) | 55.5 (48.0, 60.5) | 0.659 |
Male, n (%) | 36 (72.0%) | 29 (70.7%) | 0.894 | 26 (68.4%) | 27 (71.1%) | 1.000 |
BMI (kg/m2), mean (SD) | 24.7 (3.2) | 23.9 (2.6) | 0.181 | 24.1 (3.1) | 24.1 (6.8) | 0.995 |
Left, n (%) | 24 (48.0%) | 15 (36.6%) | 0.141 | 17 (44.7%) | 13 (34.2%) | 0.348 |
RENAL score, median (IQR) | 7.0 (6.0, 9.0) | 7.0 (7.0, 9.0) | 0.761 | 7.0 (6.0, 8.0) | 7.0 (6.8, 9.0) | 0.970 |
Tumor stage, n (%) | 0.277 | 0.373 | ||||
T1a | 43 (86.0%) | 31 (75.6%) | 32 (84.2%) | 28 (73.7%) | ||
T1b | 3 (6.0%) | 8 (19.5%) | 2 (5.3%) | 8 (21.0%) | ||
T2a | 3 (6.0%) | 2 (4.9%) | 3 (7.9%) | 2 (5.3%) | ||
T2b | 1 (2.0%) | 0 (%) | 1 (2.6%) | 0 (0%) | ||
Pathological grade (WHO), n (%) | 0.375 | 0.986 | ||||
1 | 14 (28.0%) | 17 (41.5%) | 13 (34.2%) | 15 (39.5%) | ||
2 | 32 (64.0%) | 19 (46.3%) | 23 (60.5%) | 18 (47.4%) | ||
3 | 3 (6.0%) | 5 (12.2%) | 2 (5.3%) | 5 (13.1%) | ||
4 | 1 (2.0%) | 0 (0%) | 0 (%) | 0 (%) |
Variables | 3-Arm Group (n = 38) | 4-Arm Group (n = 38) | p |
---|---|---|---|
Preparative time (min) | 11.5 (10.0, 15.0) | 15.0 (10.0, 20.0) | 0.080 |
Total operative time (min) | 120.0 (100.0, 135.0) | 146.5 (101.5, 177.8) | 0.068 |
Warm ischemia time (min) | 28.0 (21.8, 33.3) | 30.0 (25.8, 39.3) | 0.106 |
Estimated blood loss (mL) | 150.0 (100.0, 300.0) | 200.0 (100.0, 362.5) | 0.447 |
Blood transfusion, n (%) | 5 (13.2%) | 5 (13.2%) | 1.000 |
Positive surgical margin, n (%) | 1 (2.6%) | 1 (2.6%) | 1.000 |
Post-operative analgesic use (days) | 3.0 (2.0, 3.0) | 3.0 (3.0, 4.0) | 0.201 |
Post-operative stay (days) | 6.0 (5.0, 7.0) | 5.0 (5.0, 7.0) | 0.694 |
Hospital costs (CNY) | 68,406.7 (66,284.4, 74,542.7) | 76,922.5 (68,474.3, 87,432.4) | 0.006 * |
Variables | 3-Arm Group (n = 38) | 4-Arm Group (n = 38) | p |
---|---|---|---|
Complications | 9 (23.7%) | 8 (21.1%) | 1.000 |
Clavien Grade | 0.673 | ||
1 | 6 (15.8%) | 3 (7.9%) | |
2 | 2 (5.3%) | 2 (5.3%) | |
3 | 1 (2.6%) | 3 (7.9%) | |
SIRS | 2 (5.3%) | 3 (7.9%) | 1.000 |
Post-operative bleeding | 1 (2.6%) | 1 (2.6%) | 1.000 |
Wound infection | 2 (5.3%) | 1 (2.6%) | 1.000 |
Thrombosis | 4 (10.5%) | 3 (7.9%) | 1.000 |
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Zhang, Y.; Li, F.; Guo, W.; Zhang, Z.; Li, H.; Guan, W. Comparisons of Efficiency, Safety, and Hospital Costs of Four-Arm Robotic-Assisted Partial Nephrectomy (RAPN) Versus Three-Arm Technique: A Propensity Score–Matched Analysis. J. Clin. Med. 2025, 14, 2739. https://doi.org/10.3390/jcm14082739
Zhang Y, Li F, Guo W, Zhang Z, Li H, Guan W. Comparisons of Efficiency, Safety, and Hospital Costs of Four-Arm Robotic-Assisted Partial Nephrectomy (RAPN) Versus Three-Arm Technique: A Propensity Score–Matched Analysis. Journal of Clinical Medicine. 2025; 14(8):2739. https://doi.org/10.3390/jcm14082739
Chicago/Turabian StyleZhang, Yan, Fan Li, Wenhao Guo, Zongbiao Zhang, Heng Li, and Wei Guan. 2025. "Comparisons of Efficiency, Safety, and Hospital Costs of Four-Arm Robotic-Assisted Partial Nephrectomy (RAPN) Versus Three-Arm Technique: A Propensity Score–Matched Analysis" Journal of Clinical Medicine 14, no. 8: 2739. https://doi.org/10.3390/jcm14082739
APA StyleZhang, Y., Li, F., Guo, W., Zhang, Z., Li, H., & Guan, W. (2025). Comparisons of Efficiency, Safety, and Hospital Costs of Four-Arm Robotic-Assisted Partial Nephrectomy (RAPN) Versus Three-Arm Technique: A Propensity Score–Matched Analysis. Journal of Clinical Medicine, 14(8), 2739. https://doi.org/10.3390/jcm14082739