体外循环和机器人辅助下行肾癌合并Ⅳ级下腔静脉癌栓的手术经验

Application of extracorporeal circulation and robotic assisted technology in patients undergoing renal carcinoma and level Ⅳ inferior vena cava tumor thrombi resection surgery

目的回顾性总结本院近年来在体外循环和机器人辅助下行肾癌合并Ⅳ级下腔静脉癌栓的外科根治手术的病例,探讨此类手术的可行性及安全性。方法选择2016年1月至2018年6月,在本院行肾癌合并Ⅳ级下腔静脉癌栓的外科手术5例患者,其中男性4例,女性1例。记录术前、术中、术后临床资料并进行统计分析。结果本组患者术中无死亡,术后1例患者于术后第一天死亡,原因是大出血及凝血功能紊乱。所有患者病理切缘均为阴性。手术时间510(337.5~653.3)min,体外循环时间72(51~87)min。结论在体外循环和机器人辅助下行肾癌合并Ⅳ级下腔静脉癌栓根治性切除手术,手术安全,效果良好,值得推广。

Objective To investigate the feasibility and safety of robotic assisted surgery for renal carcinoma and level IV inferior vena cava tumor thrombi undergoing extracorporeal circulation.Methods From January 2016 to June 2018,five patients with renal carcinoma and level IV inferior vena cava tumor thrombi were selected for surgical treatment in our hospital,including 4 males and1 female.The perioperative clinical data were recorded and analyzed.Results There was no operative death.One patient died on the first day after operation because of massive hemorrhage and coagulation disorder.The pathological result showed that tumor margin of all patients was negative.The operation time was 510(337.5-653.3)minutes,and the cardiopulmonary bypass time was 72(51-87)minutes.Conclusion extracorporeal circulation can be used in robotic assisted renal carcinoma and levelⅣinferior vena cava tumor thrombi resection surgery safely and effectively.