目的：：探讨合并腹部手术史的达芬奇机器人泌尿手术的临床疗效及安全性.方法：回顾性分析12例合并腹部手术史并实施达芬奇机器人辅助腹腔镜手术患者的临床资料,男8例,女4例,年龄48~65岁.患者既往均有腹部手术史,手术方式包括膀胱根治性切除及双侧输尿管皮肤造口术3例,前列腺癌根治术5例,孤立肾肾盂切开取石及成形术4例.结果：手术均获成功,无中转开腹病例及相关脏器损伤发生.膀胱根治性切除及双侧输尿管皮肤造口术平均手术时间(410±30)min,平均出血量(740±100)ml,平均住院时间(17±1)d.前列腺癌根治术平均手术时间(210±20) min,平均出血量(240±100)ml,术后胃肠功能恢复时间5~7 d,平均(6±1)d,平均住院时间(11±1)d.右侧孤立肾肾盂切开取石及肾盂成形术平均手术时间(80±20)min,平均出血量(60±15)ml,术后胃肠功能恢复时间3~6 d,平均(4±1)d,平均住院时间(7±1)d.结论：达芬奇机器人泌尿系统手术可在某些合并腹部手术史病例安全有效的实施,但需严格挑选病例,远期疗效有待进一步研究.%Objective:To analyze the clinical data and safety of robot-assisted laparoscopic urological surgery complicated with abdominal surgery history.Methods:Clinical data of 1 2 cases of robot-assisted laparoscopy uro-logical surgeries were retrospectively analyzed.Eight patients were male and 4 were female.All patients had ab-dominal surgery history,and the urological operations were needed.Surgical procedures included robot-asisted radical cystectomy (RARC)in 3 cases,robot-assistde radical prostatectomy (RARP)in 5 cases,and robot-assis-ted lithotomy and pyeloureteroplasty in 4 cases.Results:All the operations were accomplished successfully with no conversions.The mean operative time in RARC group was (410±30)min,the mean blood loss was (740±100) mL,and the mean hospital stay was (17±1)days.In RARC group,the mean operative time was (210±20)min, the mean blood loss was (240±100)mL,the gastrointestinal function recovered in (6±1)days,and the mean hospital stay was (11±1)days.In robot-assisted lithotomy and pyeloureteroplasty group,the mean operative time was (80±20)min,the mean blood loss was (60±15)mL,the gastrointestinal function recovered in (4±1) days,and the mean hospital stay was (7±1)days.Conclusions:Robot-assisted laparoscopic surgery is safe and effec-tive in the selected patients complicated with abdominal surgery history.The long-term efficacy should be investigated continuously.
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