小儿麻痹后遗症患者机器人辅助肾肿瘤根治术的体位探讨

Position management of robot-assisted radical resection of renal malignancy in patients with sequelae of poliomyelitis

目的:探讨小儿麻痹后遗症患者机器人辅助下肾肿瘤根治术的安全体位。方法:回顾性分析2021年4月—2022年6月中山大学附属第一医院泌尿外科收治的3例接受机器人肾恶性肿瘤根治术的小儿麻痹后遗症患者临床资料、术中体位情况和临床资料。结果:3例患者均成功实施机器人辅助下肾盂癌或肾癌根治手术,无中转开腹。术中采用了截石位、改良截石位和左侧斜仰60°体位,患者术中体位转换顺利进行,未出现机器人操作钳相互碰撞和挤压等情况,未出现需要临时改变机器人Trocar位置或增加Trocar的情况。手术顺利完成,术后无压疮,肢体神经功能完好,无肢体感觉异常或运动功能异常。结论:采用改良的体位进行小儿麻痹后遗症患者机器人辅助下肾恶性肿瘤根治术是安全可行的。

Objective:To explore the safe surgical position of robot-assisted radical resection of renal malignancy for patients with sequelae of poliomyelitis.Methods:The clinical data of 3 patients with sequelae of poliomyelitis who underwent robot-assisted renal malignancy resection at Department of Urology,the First Affiliated Hospital of Sun Yat-sen University from April 2021 to June 2022 were retrospectively analyzed.Results:All the 3 cases of robot-assisted radical resection of renal malignancy were successfully completed without conversion to laparotomy.Lithotomy position,modified lithotomy position and left lateral 60°recumbent position were used and the postion changes successfully performed during surgery.No collisions or compressions of robotic arms was observed,and there was no need for changing the positions of robotic Trocars or adding new Trocars during operation.All surgeries were successfully completed without pressure ulcers,limb paresthesia or motor function abnormalities after operation.Conclusion:Using appropriate and modified surgical position is safe and feasible to perform robot-assisted radical resection of renal malignancy for patients with sequelae of poliomyelitis.