Abstract: Objective To evaluate the effect of robotassisted partial nephrectomy (RAPN) and 4K ultra-high-definition laparoscopic partial nephrectomy (4K-LPN) in the treatment of localized renal cell carcinoma.Mtheods A retrospective analysis was conducted on 63 patients with localized renal cell carcinoma who underwent partial nephrectomy at Huanggang Central Hospital from April 2022 to August 2024.Based on the surgical approach,patients were divided into the RAPN group (n=31) and the 4K-LPN group (n=32).The preoperative baseline characteristics,perioperative data,tumor features,hospital stay,total hospitalization costs,and short-term postoperative complications were compared between the two groups.Results The intraoperative blood loss in the RAPN group and the 4K-LPN group was (151.2±13.5)ml and (184.6±14.0)ml respectively,and the warm ischemia time of the kidneys was (21.9±3.8) minutes and (24.3±3.5) minutes respectively.The operation times were (179.6±21.4) minutes and (196.4±31.6) minutes respectively.The increase in creatinine one day after the operation was (12.8±14.2 )μmol/L and (21.4±14.6)μmol/L respectively.There was a statistically significant difference between the two groups (P< 0.05).However,the total hospitalization cost was significantly higher in the RAPN group (38 798.1±10 609.3 CNY vs.27 925.9±5 793.9 CNY,P<0.05).No significant differences were observed in positive surgical margin rates (P>0.05).Additionally,there were no statistically significant differences between the two groups regarding intraoperative transfusion rates,drainage tube removal time,catheter removal time,postoperative hospital stay,or 2-week postoperative complication rates (P>0.05).Conclusion Compared with 4K-LPN,RAPN offers significant advantages,including reduced intraoperative blood loss,shorter renal warm ischemia time,shorter operative duration,and better renal function preservation.However,the high cost of robotic surgery remains a major limiting factor for its widespread adoption.

Key words: robot-assisted laparoscopy, 4K ultra-high definition laparoscopy, partial nephrectomy, localized renal cell carcinoma