机器人辅助腹腔镜保留肾单位肾部分切除术的初步经验(附4例报告)

Robot-assisted laparoscopic partial nephrectomy( report of 4 cases)

目的总结机器人辅助腹腔镜保留肾单位肾部分切除术的手术经验,探讨此术式疗效及安全性。方法回顾分析实施机器人辅助腹腔镜下肾部分切除术4例(2例男性,2例女性)患者临床资料。结果本组手术均成功完成,无中转开放手术者。手术时间125~150 min,平均140.0 min;术中失血量30~100 m L,平均85.0 m L,无术中输血;热缺血时间12~30 min,平均21.0 min;无术中并发症。术后住院7~11 d,平均8.5 d。术后病理检查均为肾透明细胞癌,Furhman分级均为Ⅱ级,肿瘤最大径2.5~4.3 cm,平均3.1 cm,肿瘤切缘均为阴性。结论机器人辅助腹腔镜保留肾单位肾部分切除术安全可靠,疗效确切,在肾肿瘤的完整切除及肾脏创面的缝合上有明显的优势。

Objective To summarize our clinical experience of robot-assisted laparoscopic partial nephrectomy,and to discuss its efficacy and safety. Methods Retrospective analysis of clinical data of 4 patients underwent robot-assisted laparoscopic partial nephrectomy utilizing the Da Vinci surgical system( RALPN). Two patients were male and the others were female. Results All the operations were accomplished successfully,The duration of the surgery was 125 ~ 150 min,with an average of 140. 0min. The blood loss was 30 ~ 100 ml,with an average of 85. 0ml,and the intraoperative blood transfusion was unnecessary. The warm ischemia time was 12 ~ 30 min,with an average of 21.0min. There was no intraoperative morbidity,and no conversion to open surgery. The postoperative length of hospitalization was 7 ~ 11 d,with an average of 8. 5d. The postoperative pathology showed renal clear cell carcinoma with Furhman Grade II in all cases. The maximum diameters of the tumors were 2. 5 ~ 4. 3cm,with an average of 3. 1cm. The tumor resection margin was negative in all cases. Conclusions Robotassisted laparoscopic partial nephrectomy is safe and effective for small local renal tumors.