Objective To discuss the safety and feasibility of robot-assisted laparoscopic partial nephrectomy (RALPN). Methods A retrospective study was made on 99 patients treated by RALPN with the da Vinci system from August 2013 to December 2015 by the same performer.The tumor was 1.5-8 cm in diameter (median, 3.0 cm). Results The RALPN was successfully accomplished in all the 99 cases, and no conversion to open surgery was required .The mean operative time was 72.5 min ( range, 55-150 min), the mean hemorrhage was 76 ml (range, 10-200 ml), the mean renal ischemic time was 21 min (range, 8-28 min), and the mean time of drainage was 3.1 days (range, 2-11 days).Postoperative pathological examinations showed negative resection margins in all the cases , including 80 cases of renal clear cell carcinoma , 2 cases of chromophobe renal cell carcinoma , 4 cases of papillary renal cell carcinoma , 1 case of renal granulosa cell carcinoma , 1 case of multilocular cystic renal cell carcinoma , 1 case of metanephric adenoma , 3 cases of nephrocytosis , 4 cases of angiomyolipoma and 3 cases of oncocytoma .A follow-up for 5-20 months (mean, 11 months) was carried out.No patients got relapse or metastasis except one died of brain metastasis after 1 year. Conclusion RALPN is a safe and reliable operation .%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72.5 min;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.
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