经后腹腔途径行机器人辅助腹腔镜与传统腹腔镜下肾部分切除术的比较研究  

The comparative research between robot-assisted laparoscopy and conventional Laparoscopy for partial nephrectomy through retroperitoneal approach

作　　者：刘宇保 俞能旺[3] 宋华[3] 沈弋祯[3] 张爱民[3] 

机构地区：[1]北京清华长庚医院泌尿外科 [2]清华大学医学中心,北京102218 [3]济南军区总医院泌尿外科

出　　处：《微创泌尿外科杂志》2014年第5期274-276,共3页Journal of Minimally Invasive Urology

摘　　要：目的：：总结经后腹腔途径行机器人辅助腹腔镜与传统腹腔镜下手术切术肾肿瘤的手术治疗经验,探讨机器人辅助腹腔镜的疗效及优势.方法：2012年5月~2013年8月,收治3例肾肿瘤患者进行机器人辅助腹腔镜下肾部分切除术(RALPN),同期选取3例行传统腹腔镜下手术切术(LPN)肾肿瘤的患者资料进行分析.结果：6例手术均取得成功.其中RALPN术3例手术时间(不包括术前机器人准备时间)110~180 min(平均145 min),出血量50~100 ml,术后2~3天拔除引流管,3天左右下床活动,术后住院时间8~10天.术后2周复查未见局部病灶残留,肾功能与术前无明显变化.3例行LPN术手术时间为120~200 min(平均160 min),出血量80~150 ml,术后3~4天拔除引流管,4~5天下床活动,术后住院时间9~12天.术后2周复查未见局部病灶残留,肾功能与术前无明显变化.结论：RALPN在手术出血及术后患者恢复等方面与LPN相比更具一定优势,手术效率更高,操作灵活,创伤小,疗效确切.Objective:To compare the treatment experience between conventional laparoscopy with robot-assisted laparoscopy(da Vinci Si System)for partial nephrectomy through retroperitoneal approach,and discuss curative effect and advantages of robotic system.Methods:Between May 2012 and August 2013,3patients with renal tumor were performed robotic-assisted laproscopic partial nephrectomy(RALPN).During the same period,3patients with renal tumor were performed conventional laparoscopic partial nephrectomy(LPN).Results:All procedures were performed successfully.The operative time for RALPN was110-180minutes(mean 145minutes);blood loss was 50-100 mL,drain removal time was 2-3days.The hospital stay was 8-10 days with 3days of immobilization.Radiological examination found no local residual tumor,and the postoperative serum creatinine level was norma1 two weeks after operation.The operative time for conventional LPN was 120-200minutes(mean 160minutes);blood loss was 80-150 mL,drain removal time was 3-4days.The hospital stay was 9-12 days with 4-5days of immobilization.Radiological examination found no local residual tumor,and the postoperative serum creatinine level was norma1 two weeks after operation.Conclusions:RALPN through retroperitoneal approach could reduce the suturing time and blood loss and has the merits of small wound and early recovery than conventional LPN.

关 键 词：肾肿瘤 达芬奇机器人手术系统 后腹腔镜术 

分 类 号：R737.11[医药卫生—肿瘤]