摘要
肾部分切除术目前已成为T1期肾肿瘤的优先推荐术式,该手术要求实现肿瘤切缘阴性、无围手术期严重并发症发生、最大程度保护肾功能的"三连胜"。肾门部肿瘤与肾蒂血管、肾盂及上段输尿管毗邻,由于其特殊的解剖学位置,一直以来都被公认为是泌尿外科富有挑战性的手术。达芬奇机器人手术系统在肾门部肿瘤切除及创面缝合方面具有明显优势,目前我国许多医学中心都成功开展了这方面的手术,本文总结了本中心在该领域的手术技巧及初步经验,认为通过完善术前评估、选择恰当手术入路、确保完整切除肿瘤、严密缝合创面,缩短肾脏热缺血时间,便可安全有效地完成手术,实现肾部分切除手术的"三连胜"。
The partial nephrectomy has been recommended for patients with T1 stage kidney neoplasms by many guidelines.This surgery requires intact tumor resection with negative margin,no severe perioperative complications,and the maximal renal function preservation,which are called as＂Trifecta＂.The renal hilar mass is adjacent to renal pedicle,pelvis,and upper ureter,and it is very changeling for urologists to perform a successful partial nephrectomy for patients with renal hilar mass owing to its unique anatomic characters.The da Vinci robotic surgical platform has many advantages in dealing with renal hilar mass resection and nephrorrhaphy,and many domestic medical centers have successfully performed robotic assistant laparoscopic partial nephrectomy for patients with renal hilar mass.In this article,we summarized our initial surgical technique and experience in this field.We argued that better preoperative tumor anatomic evaluation,precise surgical approach selection,intact tumor resection,well-sutured tumor bed with complete nephrorrhaphy,and limited kidney warm ischemia time were essential to the safety and efficacy of robotic assistant laparoscopic partial nephrectomy for patients with renal hilar mass,as the principle of＂Trifecta＂indicated.
作者
吴大鹏
朱国栋
WU Da peng;ZHU Guo dong(Department of Urology,the First Affiliated Hospital of Xi＇an Jiaotong University,Xi＇an 710061,China)
出处
《现代泌尿外科杂志》
CAS
2018年第7期487-490,共4页
Journal of Modern Urology
关键词
肾肿瘤
肾部分切除术
肾门
机器人
微创
renal mass
partial nephrectomy
renal hilum
robotic
minimal invasive
