机器人辅助腹腔镜肾部分切除术治疗小肾癌的优势  

Advantages of robot-assisted laparoscopic partial nephrectomy in the treatment of small renal cancer

作　　者：何威[1] 徐兆平[1] 祝宇[1] 张荣明[1] 钟山[1] 王先进[1] 王晓晶[1] 沈周俊[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院泌尿外科,上海200025

出　　处：《临床泌尿外科杂志》2013年第10期721-724,共4页Journal of Clinical Urology

摘　　要：目的:通过比较机器人辅助腹腔镜肾部分切除术(robot-assisted laparoscopic partial nephrectomy,RALPN)、腹腔镜肾部分切除术(laparoscopic partial nephrectomy,LPN)和开放性肾部分切除术(open partial nephrectomy,OPN),探讨机器人辅助腹腔镜肾部分切除术在治疗小肾癌方面的优势。方法:2009年1月~2013年5月,我科共完成50例小肾癌的肾部分切除术,其中12例RALPN,15例LPN,23例OPN。将三组患者术前基线情况、手术数据和术后GFR变化进行比较。结果:三组患者术前基线情况差异无统计学意义(P>0.05)。50例手术均顺利完成,除LPN组1例术后出现尿漏,其余无术后并发症。RALPN和OPN在手术时间(operating time,OT)、热缺血时间(warm ischemic time,WIT)、失血量(estimated blood loss,EBL)方面较LPN有优势(P<0.05),RALPN在住院时间(hospital stay,HS)较LPN和OPN占优势(P<0.05)。无论哪种术式,对患侧肾功能均无明显影响(手术前后GFR比较,P>0.05)。结论:RALPN是一种创伤小、疗效确切、安全可靠的术式。同LPN比较,其优势明显。同OPN相比,也有恢复更快的优势。在不考虑手术费用的前提下,RALPN是治疗小肾癌的优先选择。Objective： To discuss the advantages of robot-assisted laparoscopic partial nephrectomy （RALPN） in the treatment of small renal cancer compared with laparoscopic partial nephrectomy （LPN） and open partial ne- phrectomy （OPN）. Method： Fifty partial nephrectomies for small renal cancer were performed from January 2009 to May 2013, which included 12 RALPN, 15 LPN and 23 OPN. The baseline parameters, operation data and perioperative GFR changes of three groups were analyzed. Result： The baseline parameters of three groups did not show a significant difference statistically （P^0.05）. All the procedures were fulfilled successfully. The recovery was uneventful except urine leakage encountered in one case of LPN. RALPN and OPN were superior to LPN in terms of operating time （OT）, warm ischemic time （WIT） and estimated blood loss （EBL） （P〈0.05）, and hos- pital stay （HS） of RALPN was shorter than LPN or OPN （P〈0.05）. No significant GFR decrease was identified in all three groups （P〈0.05）. Conclusion： RALPN is a minimally invasive procedure with confirmed efficacy and safety which is superior to LPN or OPN. RALPN is a better choice when the cost is not taken into account.

关 键 词：小肾癌 肾部分切除术 机器人手术 腹腔镜手术 

分 类 号：R737.11[医药卫生—肿瘤]