机器人辅助腹腔镜马蹄肾峡部切除术在症状性马蹄肾治疗中的应用  

Application of robot-assisted laparoscopic isthmectomy for the treatment of symptomatic horseshoe kidney

作　　者：安凌悦 张珩 熊敏[1] 罗成功 徐彬 李凯[1] 王超[2] 许元钊 田野[1] 罗光恒 班勇[1] An Lingyue;Zhang Heng;Xiong Min;Luo Chenggong;Xu Bin;Li Kai;Wang Chao;Xu Yuanzhao;Tian Ye;Luo Guangheng;Ban Yong(Department of Urology,Guizhou Provincial People′s Hospital,Guiyang550002,China;Department of Medical Imaging,Guizhou Provincial People′s Hospital,Guiyang550002,China;Graduate School of Medicine,Zunyi Medical University,Zunyi563006,China)

机构地区：[1]贵州省人民医院泌尿外科,贵州550002 [2]贵州省人民医院影像科,贵州550002 [3]遵义医科大学研究生院,遵义563006

出　　处：《中华医学杂志》2024年第48期4427-4430,共4页National Medical Journal of China

摘　　要：为了探讨机器人辅助腹腔镜马蹄肾峡部切除术治疗症状性马蹄肾的可行性及安全性,回顾性分析2021年1月1日至2023年12月31日贵州省人民医院4例症状性马蹄肾患者的临床资料,主要手术方式为机器人辅助腹腔镜下马蹄肾峡部切除术、肾固定术、肾盂成形术及肾盂切开取石术。结果4例患者手术成功,1例患者合并结石,平均手术时间179.8 min,平均出血量为49.5 ml,完成随访的患者在3个月、6个月、1年及2年内肾脏解剖维持正常,与术前相比,肾积水明显改善,血肌酐正常,围手术期未出现手术相关并发症。可见机器人辅助腹腔镜马蹄肾峡部切除术治疗症状性马蹄肾安全可行,能有效恢复马蹄肾解剖结构异常,恢复输尿管自然走形,防止马蹄肾峡部压迫输尿管。The current study aimed to investigate the feasibility and safety of robot-assisted laparoscopic resection of the isthmus in patients with symptomatic horseshoe kidney.A retrospective analysis of clinical data from four patients with symptomatic horseshoe kidney treated between January 1,2021 and December 31,2023 at Guizhou Provincial People′s Hospital was conducted.The main surgical procedures included robot-assisted laparoscopic resection of the isthmus,kidney fixation,pyeloplasty,and pyelolithotomy.All four patients underwent successful surgery.One patient had concomitant calculi.The mean operative time was 179.8 minutes,with an average blood loss of 49.5 ml.In patients followed up for 3 months,6 months,1 year,and 2 years postoperatively,renal anatomy remained normal,significant improvement in hydronephrosis was observed compared to preoperative status,serum creatinine levels returned(maintained)to normal status,and no surgery-related complications occurred during the perioperative period.This study reports the safety and feasibility of robot-assisted laparoscopic resection of the isthmus in patients with symptomatic horseshoe kidney.This surgical approach effectively restores the abnormal anatomical structure of the horseshoe kidney,reestablishes the natural course of the ureter,and prevents compression of the ureter by the isthmus of the horseshoe kidney.

关 键 词：症状性马蹄肾 机器人辅助 马蹄肾峡部切除术 手术技术 

分 类 号：R73[医药卫生—肿瘤]