机器人辅助单孔腹腔镜治疗输尿管中下段狭窄的初步体会  

Preliminary experience of robot-assisted single-port laparoscopic surgery in the treatment of middle and lower ureteral stricture

作　　者：翟新宇[1] 谈鸣岳 葛旻垚[1] 万众 徐东亮 ZHAI Xinyu;TAN Mingyue;GE Minyao;WAN Zhong;XU Dongliang(Urology Center,Shuguang Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海中医药大学附属曙光医院泌尿中心,上海201203

出　　处：《机器人外科学杂志（中英文）》2023年第6期525-532,共8页Chinese Journal of Robotic Surgery

摘　　要：目的:探讨机器人辅助单孔腹腔镜治疗输尿管中下段狭窄的可行性和有效性。方法:回顾性分析2020年11月—2021年9月收治8例输尿管中下段狭窄患者的临床资料,其中4例为结石手术后引起的继发性输尿管狭窄,2例为盆腔手术后引起的继发性输尿管狭窄,1例为输尿管多发息肉引起的继发性输尿管狭窄,1例为先天性巨输尿管症。左侧6例,右侧2例,中段4例,下段4例。2例患者术前行肾穿刺造瘘术。输尿管狭窄平均长度为(2.31±0.65)cm。8例患者中4例行机器人辅助单孔腹腔镜下输尿管狭窄段切除并端端吻合术,4例行机器人辅助单孔腹腔镜下输尿管膀胱再植术,均为经脐单孔入路。结果:8例手术均顺利完成,无中转开放,手术时间为(98.13±18.41)min,术中出血量为(29.38±9.04)ml,平均住院天数为(5.75±1.28)d。围手术期无明显并发症发生,术后平均随访6个月,患者肾积水均较术前明显减轻,患肾功能明显好转。结论:机器人辅助单孔腹腔镜手术治疗输尿管中下段狭窄安全、有效。Objective:To evaluate the safety and efficacy of robot-assisted single-port laparoscopic surgery in the treatment of middle and lower ureteral stricture.Methods:The clinical data of 8 patients with middle/lower ureteral stricture admitted in our hospital from November 2020 to September 2021 were analyzed retrospectively.Among them,4 cases were secondary ureteral stricture caused by stone operation,2 cases were secondary ureteral stricture caused by pelvic operation,1 case was secondary ureteral stricture caused by multiple ureteral polyps,and 1 case of congenital giant ureter.There were 6 cases on the left side,2 cases on the right side,4 cases in the middle segment and 4 cases in the lower segment.2 patients underwent nephrostomy before surgery.The average length of ureteral stricture was(2.31±0.65)cm.4 cases underwent robot-assisted single-port laparoscopic ureteroureterostomy,and another 4 cases underwent robot-assisted single-port laparoscopic ureteral reimplantation.Results:All surgeries were completed successfully with no conversion to open surgery.The average operative time was(98.13±18.41)min,with the average intraoperative blood loss of(29.38±9.04)ml and the average hospital stay of(5.75±1.28)d.There were no obvious complications found during perioperative period.The hydronephrosis was significantly relieved and the renal function was significantly improved in the follow-up(average,6 months).Conclusion:Robot-assisted single-port laparoscopic surgery is safe and effective in the treatment of middle and lower ureteral stricture.

关 键 词：机器人辅助手术 单孔腹腔镜手术 输尿管狭窄 

分 类 号：R695[医药卫生—泌尿科学]