机器人辅助腹腔镜肾结核“去顶削底”保留肾单位手术2例报告  

Robot-assisted laparoscopic nephron-sparing surgery for"de-roofing and peeling bottom"of renal tuberculosis:a report of 2 cases

作　　者：班勇[1] 安凌悦 姜浩 徐彬 罗光恒 BAN Yong;AN Lingyue;JIANG Hao;XU Bin;LUO Guangheng(Department of Urology,Guizhou Provincial People's Hospital,Guiyang,550002,China)

机构地区：[1]贵州省人民医院泌尿外科,贵阳550002

出　　处：《临床泌尿外科杂志》2025年第1期35-38,共4页Journal of Clinical Urology

摘　　要：目的:评价“去顶削底”技术在肾部分切除术治疗局部肾结核中的安全性和可行性。方法:2例肾结核患者术前均进行12个月以上抗结核治疗,通过CT影像学充分评估后在全身麻醉下行机器人辅助腹腔镜肾结核“去顶削底”保留肾单位手术。结果:2例患者术后病理学证实为肾结核,手术成功率为100%,均未出现手术并发症;患者术后血沉、尿常规、血常规恢复正常,术后血肌酐与术前相比无明显改变,肾小球滤过率稍有下降;患者术后继续进行抗结核治疗,停药随访期间患者无结核复发。术后1年复查影像学提示患肾形态良好。其中1例患者完成回肠膀胱扩大手术,未见腹腔粘连。结论:机器人辅助腹腔镜“去顶削底”技术治疗局限性肾结核,疗效确切,具有一定的安全性和可行性。Objective:To evaluate the safety and feasibility of"de-roofing and peeling bottom"technique in partial nephrectomy for local renal tuberculosis.Methods:After preoperative anti-tuberculosis treatment for more than 12 months and adequate evaluation by CT scan,two patients with renal tuberculosis underwent robot-assisted laparoscopic"de-roofing and peeling bottom"nephron-sparing surgery under general anesthesia.Results:Two patients were diagnosed as renal tuberculosis by postoperative pathology.The success rate of operation was 100%,and no complications occurred.The erythrocyte sedimentation rate,urine routine and blood routine returned to normal after operation.There was no significant change in serum creatinine after operation,and the glomerular filtration rate decreased slightly.The patients continued anti-tuberculosis therapy after operation,and no tuberculosis recurrence occurred during the follow-up period after drug withdrawal.The imaging examination at 1 year after operation showed that the shape of the affected kidney was good.One patient underwent ileal cystoplasty without abdominal adhesion.Conclusion:The robot-assisted laparoscopic"de-roofing and peeling bottom"technique was an effective,safe and feasible treatment for localized renal tuberculosis.

关 键 词：机器人辅助腹腔镜 肾结核 “去顶削底”保留肾单位 

分 类 号：R737.11[医药卫生—肿瘤]