机器人辅助腹腔镜下腔静脉癌栓取出术10例随访分析

Follow-up analysis of 10 cases with robot-assisted laparoscopic inferior vena cava tumor thrombectomy

目的探讨机器人辅助腹腔镜下腔静脉癌栓取出术的可行性和安全性。方法回顾性分析10例机器人辅助腹腔镜下腔静脉癌栓取出术患者的临床资料,并随访分析。结果10例患者均经B超、CT或MRI检查明确诊断,3例为左侧肾癌伴腔静脉癌栓,术前行左肾动脉栓塞术,7例为右侧肾癌伴腔静脉癌栓,其中1例术前下腔静脉造影提示下腔静脉闭塞。10例均行机器人辅助腹腔镜下腔静脉癌栓取出术,手术顺利,术后病理证实均为肾癌伴下腔静脉癌栓。术后随访3~18个月,靶向药物治疗8例,2例未予特殊治疗。结论肾肿瘤根治性切除+腔静脉癌栓取出术可有效提高患者的生存率,经过充分术前准备及评估,机器人辅助腹腔镜下腔静脉癌栓取出术是安全可行的。

Objective To explore the feasibility and safety of robot-assisted laparoscopic inferior vena cava tumor thrombectomy. Methods We retrospectively analysed the clinical and follow-up data of 10 patients with robot-assisted laparoscopic inferior vena cava tumor thrombectomy. Results Ten patients were diagnosed by B ultrasound CT or MRI. The 3 cases had left renal cancer with vena cava tumor thrombus, then left renal artery embolism was performed preoperatively. The 7 cases were right renal cancer with vena cava tumor thrombus, and one of the patients was found inferior vena cava occlusion by preoperative inferior vena cava angiography. The 10 patients underwent robot-assisted laparoscopic inferior vena cava tumor thrombectomy, and the operations were all successful. The postoperative pathological results confirmed the diagnosis of renal cancer with inferior vena cava tumor thrombus.Conclusions Radical nephrectomy and inferior vena cava thrombectomy can effectively prolong the survival rate of patients. After adequate preoperative preparation and evaluation, robot-assisted laparoscopic inferior vena cava tumor thrombectomy is safe and feasible.