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,探讨机器人辅助腹腔镜手术的效果和优势。方法:回顾分析单术者2015年2月~2016年6月应用机器人辅助腹腔镜行肾部分切除术的85例患者临床资料。结果:85例患者均完成腹腔镜下肾部分切除术,无改变手术方式病例;肿瘤大小1.0cm×2.0cm^9.0cm×10.0cm。手术时间(不包括机械臂准备时间)65~128min,肾动脉阻断时间9~33min,术中出血10~450ml;术后3~5d下床活动,4~5d拔除引流管,术后住院时间5~10d。透明细胞癌70例,血管平滑肌脂肪瘤7例,乳头状肾细胞癌4例,嫌色细胞瘤2例,嗜酸性细胞瘤1例,肾孤立性纤维瘤1例,无切缘阳性病例。术后1例因出血行介入栓塞术。随访3~16个月,无局部复发及远处转移,患者肾功能均保持正常水平。结论:机器人辅助腹腔镜肾部分切除术手术操作精细便利,手术操作熟练术者实行此术式明显优于传统腹腔镜手术,尤其适合于较大占位、多发占位或复杂位置占位等特殊类型肾部分切除术。
Objective:To summarize single surgeon's experience of robot-assisted laparoscopic partial nephrectomy,and to discuss its efficacy and advantage.Methods:Between Feb.2014 and June 2016,85 cases of renal tumor receiving robot-assisted laparoscopic partial nephrectomy were retrospectively analyzed Results:All the operations were accomplished successfully without conversion to open surgery.The volume of the mass was 1.0cm×2.0cm-9.0cm×10.0cm.The operative time(not including preoperative set-up time of da Vinci Si surgical system)was 65-128 min.The warm ischemia time was 9-33 min.The estimated blood loss was 10-450 mL.The lying time in bed was 3-5days.The drainage tubes were removed in 4-5days.The hospital stay was 5-10 days.Pathologicaly,there were 70 cases of clear renal cellcarcinoma,7cases of angioleiomyolipoma,4cases of papillary renal cell carcinoma,2cases of chromophobic adenoma,one case of oncocytoma and one case of solitary fibrous tumor.No resection margin positive case was found.One case received the interventional embolization because of postoperative hemorrhage.Neither local recurrence nor metastasis was observed during a follow-up period of 3-16 months.Renal function of all patients was in the normal range.Conclusions:Robot-assisted laparoscopic partial nephrectomy has the benefits of peculiar features such as more accurate operation and more clear vision.It is a prior choice in the case of the complex renal tumor.
出处
《微创泌尿外科杂志》
2017年第1期19-23,共5页
Journal of Minimally Invasive Urology
