摘要
目的:总结机器人辅助腹腔镜肾部分切除术的手术经验,探讨该术式疗效及安全性.方法:2013年5月～2013年8月对20例T1期肾肿瘤患者行达芬奇机器人(da Vinci Si机器人手术系统)辅助腹腔镜肾部分切除术,收集手术相关资料与国外此手术初期资料进行比较分析.结果:20例手术均获成功,无一例转换术式.肿瘤平均直径2.9(0.8～6.0)cm,手术时间(不包括术前机器人准备时间)119(80～180) min,肾动脉阻断时间17(10～25)min,术中出血量88(10～300)ml.术后均3d下床活动,2.6(0～7)d拔除引流管,术后住院6.8(5～11)d,术后血清肌酐升高16.5(-1.5～48.6)μmol/L.围手术期无并发症.术后病理检查提示20例均为透明细胞癌,所有肿瘤组织病理检查切缘为阴性.随访1～3个月,无局部复发及远处转移,肾功能均在正常范围内.结论:机器人辅助腹腔镜肾部分切除术是一种创伤小、安全可靠、疗效确切的手术方法.随着操作熟练程度的提高,此术式优势将更加明显.
Objective:To summarize our clinical experience of robot-assisted laparoscopic partial nephrectomy(RALPN),and to discuss its efficacy and safety.Methods:Between May 2013and August 2013,20cases of T1 renal tumor treated with intraperitoneal robotic partial nephrectomy utilizing the da Vinci Si surgical system.The perioperative data were collected,and were compared with those performed the same operation in abroad and those performed laparoscopic partial nephrectomy(LPN)with the same team in internal.Results:All the operations were accomplished successfully.The mean lesion diameter was 2.9(0.8-6.0)cm;the mean operative time(not including preoperative set-up time of the da Vinci Si surgical system)was 119(80-180)min;the mean warm ischemia time were 17(10-25)min;the mean estimated blood loss was 88(10-300)ml.The patients were ambulant in the 3th postoperative days,and tubes were removaled in 2.6(0-7)d,and mean hospital stay was 6.8(5-11)d.Postoperative serum creatinine increased 16.5(-1.5-48.6)μmol/L.No intraoperative or postoperative complication occurred.Pathology revealed that all 13cases was clear cell renal cell carcinoma.All resection margins were negative.Neither local recurrence nor metastasis was observed during a follow-up of 1to 3months.Renal function of all patients was in the normal range.Conclusions:Robot-assisted laparoscopic partial nephrectomy can be safely performed in selected patients. and it is a feasible approach and a minimally invasive operation for T1 renal tumor.
出处
《微创泌尿外科杂志》
2013年第6期-,共4页
Journal of Minimally Invasive Urology
基金
卫生部行业基金子课题(201002010)
