机器人辅助与后腹腔镜肾部分切除术治疗复杂性肾肿瘤的临床效果比较  

Comparison of clinical effect of robot-assisted partial nephrectomy and retroperitoneal laparoscopic partial resection for complicated renal tumors

作　　者：赵书斌 程继文[1] 刘德云 黎承杨[1] 米华[1] 杨占斌[1] 付伟金[1] 李天宇[1] 莫林键[1] ZHAO Shu-bin;CHENG Ji-wen;LIU De-yun(Department of Urology,First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China;Department of Urology,Liutie Central Hospital of Liuzhou)

机构地区：[1]广西医科大学第一附属医院泌尿外科,广西南宁530021 [2]广西柳州市柳铁中心医院泌尿外科

出　　处：《腹腔镜外科杂志》2020年第4期293-297,共5页Journal of Laparoscopic Surgery

摘　　要：目的:观察机器人辅助与后腹腔镜肾部分切除术治疗复杂性肾肿瘤的临床应用效果。方法:将64例复杂性肾肿瘤患者根据治疗方法分为对照组与观察组,每组32例。对照组行后腹腔镜肾部分切除术,观察组行机器人辅助肾部分切除术。比较两组手术时间、热缺血时间、术中出血量,术后并发症情况、术后病理检查结果及随访结果。结果:观察组手术时间、热缺血时间短于对照组,术中出血量少于对照组(P<0.05);两组住院时间及术后迟发性出血、急性肾衰竭、尿瘘、肾功能减退等并发症发生率差异无统计学意义(P>0.05);两组术后病理检查结果差异亦无统计学意义(P>0.05)。随访结果显示,观察组复发率低于对照组(P<0.05);术后1个月,两组肌酐水平均高于术前,观察组高于对照组(P<0.05)。结论:机器人辅助肾部分切除术可能利于降低术后复发率、尽可能保留术后患肾肾单位及肾功能。Objective:To compare the clinical application of robot-assisted partial nephrectomy and retroperitoneal laparoscopic partial resection in complicated renal tumors.Methods:Sixty-four patients with complicated renal tumors were divided into control group and observation group,with 32 cases in each group.The control group received retroperitoneal laparoscopic partial resection and the observation group received robot-assisted partial nephrectomy.The operation time,warm ischemia time,intraoperative blood loss,postoperative complications,postoperative pathological findings and follow-up results were selected and compared between the two groups.Results:The operation time and warm ischemia time were shorter,the intraoperative blood loss was less,and the recurrence rate was lower in the observation group than that in the control group(P<0.05).No significant difference in hospitalization time and postoperative pathological result was found between the two groups(P>0.05).There was no significant difference in the incidence of postoperative complications such as delayed bleeding,acute renal failure,urinary fistula,and renal hypofunction(P>0.05).The creatinine level after surgery was elevated in both groups,and the postoperative creatinine level in the observation group was higher than that in the control group in 1 month after operation(P<0.05).Conclusions:Compared with traditional laparoscopic partial nephrectomy,robot-assisted partial nephrectomy is safer and more feasible in the perioperative period for complicated renal tumors,because of its advantages in shortening operation and warm ischemia time,reducing recurrence rate and preserving nephron and renal function.

关 键 词：肾肿瘤 肾部分切除术 机器人手术 腹腔镜检查 热缺血时间 

分 类 号：R737.11[医药卫生—肿瘤]