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）

摘要

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 mL，平均85．0 mL，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 ef-ficacy and safety.Methods Retrospective analysis of clinical data of 4 patients underwent robot-assisted laparoscopic partial nephrectomy u-tilizing the Da Vinci surgical system( RALPN) .Two patients were male and the others were female.Results All the operations were accom-plished successfully,The duration of the surgery was 125~150min,with an average of 140.0min.The blood loss was 30~100ml,with an av-erage of 85.0ml,and the intraoperative blood transfusion was unnecessary.The warm ischemia time was 12~30min,with an average of 21. 0min.There was no intraoperative morbidity,and no conversion to open surgery.The postoperative length of hospitalization was 7~11d,with an average of 8.5d.The postoperative pathology showed renal clear cell carcinoma with Furhman Grade II in all cases.The maximum diame-ters of the tumors were 2.5~4.3cm,with an average of 3.1cm.The tumor resection margin was negative in all cases.Conclusions Robot-assisted laparoscopic partial nephrectomy is safe and effective for small local renal tumors.