机器人辅助腹腔镜与后腹腔镜肾部分切除术近期临床疗效比较  

Comparative study of perioperative outcomes between robot-assisted transperitoneal laparoscopic partial nephrectomy and retroperitoneal laparoscopic partial nephrectomy

作　　者：阮东丽[1] 张更[1] 李智斌[1] 刘克普[1] 高龙[1] 孟平[1] 郑文峰[1] 杨晓剑[1] 袁建林[1] 

机构地区：[1]第四军医大学西京医院泌尿外科,西安710032

出　　处：《临床泌尿外科杂志》2016年第6期538-542,共5页Journal of Clinical Urology

摘　　要：目的：比较机器人辅助腹腔镜肾部分切除术（RALPN）与后腹腔镜肾部分切除术（RLPN）治疗肾肿瘤的疗效及安全性。方法：回顾性分析2013年5月～2015年2月我院133例行泌尿系CT检查诊断为肾肿瘤并行RLPN或RALPN的数据,RLPN为73例,RALPN为60例。通过手术时间、热缺血时间、血红蛋白下降值、住院时间、并发症等方面对两组手术的近期疗效进行比较。结果：除RLPN组有3例改开放手术外,两组患者均成功完成手术。RALPN组与RLPN组相比,手术时间分别为（140.9±51.6）min和（178.5±54.36）min,差异有统计学意义（P〈0.05）,热缺血时间、血红蛋白下降值、术中输血率、住院天数及并发症的差异均无统计学意义（P〉0.05）。术后病理肿瘤切缘均为阴性。RALPN组1例术后急性脑梗;RLPN组1例术后肠梗阻,1例术后继发出血。两组患者随访期间均无瘤生存。结论：RALPN是一种安全、有效的治疗肾肿瘤的微创术式。Objective：To compare the efficacy and safety between robot-assisted transperitoneal laparoscopic partial nephrectomy（RALPN）and retroperitoneal laparoscopic partial nephrectomy（RLPN）in treating renal tumor.Method：A retrospective review of 133 renal tumor patients from May 2013 to February 2015 was conducted.Sixty patients were performed with RALPN（RALPN group）,and 73 patients underwent RLPN（RLPN group）.The operation time,warm ischemia time,decreased hemoglobin values,intraoperative blood transfusion rate,postoperative hospital stay and postoperative complications between the two groups were observed and compared.Result：Both the two groups were performed successfully,except that three cases intraoperatively converted to open surgery in RLPN group.The operation time of RALPN and RLPN group were（140.9±51.6）and（178.5±54.36）min respectively.There was significant difference between the two groups（P〈0.05）.The warm ischemia time,decreased hemoglobin values,intraoperative blood transfusion rate,postoperative hospital stay and postoperative complications between the two groups showed no significant difference.All the pathological tumor margins were negative.In RALPN group,postoperative acute cerebral infarction was found in one case,while in RLPN group one case of intestinal obstruction and one case of secondary hemorrhage were found postoperatiovely.All patients survived with turmor free.Conclusion：RALPN is a quite effective,safe and minimally invasive surgical management for renal tumor.

关 键 词：机器人辅助 后腹腔镜 肾部分切除术 肾肿瘤 

分 类 号：R572[医药卫生—消化系统]