机器人辅助腹腔镜肾部分切除术:单一术者99例经验总结

发布时间：2018-03-30 10:08

本文选题：机器人手术系统　切入点：肾部分切除术　出处：《中国微创外科杂志》2017年03期

【摘要】：目的探讨机器人辅助腹腔镜肾部分切除术(robot-assisted laparoscopic partial nephrectomy,RALPN)的有效性、安全性。方法回顾性分析2013年8月~2015年12月单一术者应用da Vinci机器人系统完成的99例RALPN临床资料。肿瘤直径1.5~8 cm,中位数3.0 cm。结果 99例手术均成功完成,无中转开放手术。手术时间55~150 min,平均72.5min;手术出血量10~200 ml,平均76 ml;肾动脉阻断时间8~28 min,平均21 min;术后引流管拔除时间2~11 d,平均3.1 d。术后病理提示99例切缘均为阴性,其中透明细胞癌80例,嫌色细胞癌2例,乳头状肾细胞癌4例,颗粒细胞癌1例,多房囊性肾细胞癌1例,后肾腺瘤1例,肾囊肿3例,血管平滑肌脂肪瘤4例,嗜酸细胞瘤3例。随访时间5~20个月,平均11个月,1例T1期肾癌术后1年脑转移死亡,余均无局部复发、远处转移。结论 RALPN是一种安全可靠的手术方式。
[Abstract]:Objective to investigate the effectiveness of robot-assisted laparoscopic partial nephrectomyne (RALPN) in cytomegaloid assisted laparoscopic partial nephrectomy. Methods the clinical data of 99 cases of RALPN performed by da Vinci robot system from August 2013 to December 2015 were analyzed retrospectively. The diameter of tumor was 1.5cm, the median was 3.0 cm. The operative time was 55 ~ 150 min (mean 72.5 min), 10 ~ 200 ml (mean 76 ml), 828 min (mean 21 min), 211 d (average 3.1 d), 211 d (mean 3.1 d). There were 80 cases of clear cell carcinoma, 2 cases of chromophobe cell carcinoma, 4 cases of papillary renal cell carcinoma, 1 case of granular cell carcinoma, 1 case of multilocular cystic renal cell carcinoma, 1 case of posterior renal adenoma, 3 cases of renal cysts and 4 cases of angiomyolipoma. Three cases of eosinophils were followed up for 5 ~ 20 months, with an average of 11 months. One case of T1 stage renal carcinoma died of brain metastasis one year after operation. There was no local recurrence and distant metastasis in all cases. Conclusion RALPN is a safe and reliable surgical method.
【作者单位】：中国人民解放军总医院海南分院泌尿外科;中国人民解放军总医院泌尿外科;
【分类号】：R737.11

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