机器人辅助腹腔镜肾部分切除术分期治疗不同病理类型双侧肾癌1例报告并文献复习

Robot-assisted laparoscopic partial nephrectomy for the staging of bilateral renal carcinoma of different pathological types: a case report and literature review

目的:探讨机器人辅助腹腔镜肾部分切除术分期治疗不同病理类型双侧肾癌的可行性、安全性及临床疗效。方法:回顾性分析2017年12月7日南昌大学第一附属医院收治的1例双侧肾癌患者的临床资料并进行文献复习。患者左侧肾癌行机器人辅助腹腔镜不阻断肾蒂肾部分切除术,右侧肾癌行机器人辅助腹腔镜阻断肾蒂肾部分切除术。结果:两次手术均顺利完成,双侧肾癌手术时间分别为153 min(左侧)和136 min(右侧),术中出血量分别约250 mL(左侧)和150 mL(右侧),右侧肾癌手术热缺血时间为20 min,左侧肾癌手术未阻断肾蒂;术后病理报告分别为乳头状肾细胞癌(左肾);透明细胞癌(右肾)。结论:机器人辅助腹腔镜肾部分切除术分期治疗不同病理类型双侧肾癌安全可行,短期疗效满意,预后还需要长期随访。

Objective:To explore the safety and clinical efficacy of robot-assisted laparoscopic partial nephrectomy for bilateral renal cell carcinoma of different pathological types.Methods:The clinical data of a patient with bilateral renal cancer admitted to the First Affiliated Hospital of Nanchang University on December 7,2017 were retrospectively analyzed,and literature was reviewed.Robot-assisted laparoscopic partial nephrectomy without renal pedicle obstruction underwent on the left side,while robot-assisted laparoscopic partial nephrectomy with renal pedicle obstruction underwent on the right side.Results:Both operations were performed successfully.The operation time was153 min(left)and 136 min(right),and the intraoperative blood loss was about 250 mL(left)and 150 mL(right),respectively.The warm ischemia time was 20 min in the right side operation,and the renal pedicle was not blocked in the left side operation.The postoperative pathological reports revealed papillary renal cell carcinoma(the left side)and clear cell carcinoma(the right side).Conclusion:Robot-assisted laparoscopic partial nephrectomy for the treatment of bilateral renal cell carcinoma of different pathological types is safe and feasible.The short-term results are satisfactory and the prognosis needs long-term follow-up.