国产内窥镜手术机器人系统在肾部分切除术中的初步临床应用  

Initial clinical application of domestic endoscopic surgical robot system for partial nephrectomy

作　　者：李学松[1] 樊书菠 熊盛炜 代晓飞 杨昆霖 李志华[1] 孟畅 王杰 张争[1] 蔡林[1] 张崔建[1] 张中元[1] 虞巍[1] 谌诚[1] 王刚[1] 周利群[1] Li Xuesong;Fan Shubo;Xiong Shengwei;Dai Xiaofei;Yang Kunlin;Li Zhihua;Meng Chang;Wang Jie;Zhang Zheng;Cai Lin;Zhang Cuijian;Zhang Zhongyuan;Yu Wei;Shen Cheng;Wang Gang;Zhou Liqun(Department of Urology,Peking University First Hospital,Institute of Urology,Peking University,National Urological Cancer Center,Beijing 100034,China;Department of Urology,Civil Aviation General Hospital,Beijing 100123,China)

机构地区：[1]北京大学第一医院泌尿外科,北京大学泌尿外科研究所,国家泌尿、男性生殖系肿瘤研究中心,北京100034 [2]民航总医院泌尿外科,北京100123

出　　处：《中华泌尿外科杂志》2021年第5期375-380,共6页Chinese Journal of Urology

摘　　要：目的探讨康多内窥镜手术机器人系统用于肾部分切除术的安全性及有效性。方法本研究纳入2020年12月至2021年2月于北京大学第一医院就诊的符合入组条件的T1期肾肿瘤患者。纳入标准:①需要进行肾部分切除治疗的患者;②肿瘤TNM分期为T1期;③R.E.N.A.L.评分≤9分;④年龄18~75岁。排除标准:①有未控制的严重疾病或急性感染者;②有心脑血管疾病、血液系统疾病或糖尿病且不能控制,不能达到手术标准者;③有免疫系统疾病且不能控制,不能达到手术标准者;④妊娠或哺乳期妇女。所有患者均采用康多内窥镜手术机器人系统行肾部分切除术。收集患者术前、围手术期及随访等资料。结果本研究共纳入26例患者,男16例,女10例;中位年龄53(33~74)岁;中位体质指数25.99(20.90~32.91)kg/m^(2);左肾肿瘤12例,右肾肿瘤14例;肿瘤直径中位值2.2(1.0~3.5)cm。所有手术按照既定手术方案切除病变组织,热缺血时间中位值17.7(7.1~29.2)min,设备对接时间中位值4.7(2.3~9.9)min,机械臂手术时间中位值65(37~155)min,美国航空航天局任务负荷指数(NASA-TLX)评分中位值5.3(2.0~28.0)分,术中无器械相关不良事件发生。术后住院时间中位值4(4~5)d。术后病理检查示所有肿瘤切缘均为阴性。所有患者围术期及术后随访1个月均无Clavien≥Ⅱ级手术并发症发生。结论采用康多内窥镜手术机器人系统行肾部分切除术,无器械相关不良事件和手术并发症发生,该系统用于肾部分切除术安全、有效。Objective To evaluate the safety and effectiveness of Kangduo endoscopic surgical robot system for partial nephrectomy.Methods Consecutive patients with stage T1 renal tumor meeting the inclusion criteria from the Department of Urology,Peking University First Hospital from December 2020 to February 2021 were prospectively enrolled.All patients underwent partial nephrectomy with the Kangduo endoscopic surgical robot system after signing the informed consent.Clinical data including preoperative,perioperative and postoperative pathology and follow-up were collected.Results Among the 26 patients,there were 16 males and 10 females,with a median age of 53(33-74)years,and a median body mass index of 25.99(20.90-32.91)kg/m^(2).There were 12 cases of left kidney tumor and 14 cases of right kidney tumor.The median tumor diameter was 2.2(1.0-3.5)cm.The median time of warm ischemia was 17.7(7.1-29.2)minutes,and all of them were less than 30 minutes.The median docking time was 4.7(2.3-9.9)minutes,and the median time of robotic arm operation was 65.0(37.0-155.0)minutes.The median National Aeronautics and Space Administration Task Load Index(NASA-TLX)score was 5.3(2.0-28.0),and no instrument-related adverse events occurred intraoperatively.The median postoperative hospital stay was 4(4-5)days.All tumor margins were negative on pathologic reports.No ClavienⅡstage operative complications occurred in all patients during perioperative period and 1 month after the surgery.Conclusions The partial nephrectomy using the kangduo endoscopic surgical robot system were completed successfully,and no instrument-related adverse events and complications occurred,showing that this surgical system used for partial nephrectomy is safe and effective.

关 键 词：肾肿瘤 机器人手术 肾部分切除术 疗效 

分 类 号：R737.11[医药卫生—肿瘤]