摘要
目的 初步探讨机器人辅助腹腔镜肾移植术(robotic-assisted kidney transplantation, RAKT)围手术期的安全性及有效性。方法 收集2018年6月至2022年3月陆军特色医学中心泌尿外科行肾移植术的14例患者资料,其中男性8例,女性6例,年龄22~45岁。采用活体供肾机器人辅助腹腔镜下肾移植术4例(RAKT组),采用尸体供肾开放肾移植术(open kidney transplantation, OKT)10例(OKT组)。回顾性分析2组患者的动静脉吻合时间、术后住院时间、手术前后血肌酐值、术中出血量及术后并发症等。结果 14例患者均顺利完成手术,术中出血量RAKT组为(162.5±47.8)mL,明显低于OKT组的(245.1±68.5)mL(P<0.05);RAKT组动脉吻合时间为(32.5±6.5)min, OKT组为(24.3±5.3)min;RAKT组静脉吻合时间为(16.5±3.8)min, OKT组为(14.6±1.5)min;RAKT组术后7 d血肌酐(98.1±33.2)μmol/L,OKT组为(142.8±42.1)μmol/L;引流管留置时间OKT组为(10.0±1.2) d,明显长于RAKT组的(6.5±0.5) d (P<0.01);术后住院时间RAKT组为(13.0±2.5) d,明显短于OKT组的(16.3±2.1) d (P=0.01)。结论 初步证实RAKT围手术期安全有效,术后并发症较OKT少。
Objective To preliminarily investigate the safety and effectiveness of robot-assisted kidney transplantation(RAKT) in the perioperative period. Methods Clinical data of 14 patients undergoing renal transplantation in our department from June 2018 to March 2022 were collected and retrospectively analyzed. They were 8 males and 6 females, and at an age of 22 to 45 years. There were 4 patients receiving robotic-assisted laparoscopic living-donor kidney transplantation(RAKT group), and 10 cases receiving open kidney transplantation(OKT group) with deceased donor kidney. Arterio-venous anastomoses(AVAs) time, length of post-operative stay, pre-and post-operative serum creatinine levels, intraoperative blood loss, and incidence of post-operative complications were retrospectively analyzed between the patients of the 2 groups. Results The surgeries went well in the 14 patients. The amount of intraoperative blood loss was 162.5±47.8 mL in the RAKT group and 245.1±68.5 mL in the OKT group(P<0.05). The arterial anastomosis time was 32.5±6.5 min in the RAKT group and 24.3±5.3 min in the OKT group. The venous anastomosis time was 16.5±3.8 min in the RAKT group and 14.6±1.5 min in the OKT group. The blood creatinine level was 98.1±33.2 μmol/L in the RAKT group and 142.8±42.1 μmol/L in the OKT group in 7 d after surgery. The retention time of drainage tube was 10.0±1.2 d in the OKT group and 6.5±0.5 d in the RAKT group(P<0.01). The length of stay after surgery was 13.0±2.5 d in the RAKT group and 16.3±2.1 d in the OKT group(P=0.01). Conclusion RAKT is safer than OKT in the perioperative period and causes fewer postoperative complications.
作者
钟晓
兰卫华
王洛夫
张尧
张军
聂志林
李珂
袁刚
舒泽华
童大力
李耀明
刘秋礼
王鹏
江军
ZHONG Xiao;LAN Weihua;WANG Luofu;ZHANG Yao;ZHANG Jun;NIE Zhilin;LI Ke;YUAN Gang;SHU Zehua;TONG Dali;LI Yaoming;LIU Qiuli;WANG Peng;JIANG Jun(Department of Urology Army Medical Center of PLA,Chongqing,400042,China)
出处
《陆军军医大学学报》
CAS
CSCD
北大核心
2022年第18期1862-1866,共5页
Journal of Army Medical University
基金
重庆市科卫联合医学科研项目(2020MSXM063)
陆军军医大学临床医学科研人才培养计划(2018XLC3043)。
关键词
机器人肾移植
肾移植
围手术期
robot-assisted kidney transplantation
kidney transplantation
perioperative period
