机器人辅助单孔腹腔镜肾切取联合工作台手术及自体肾移植术治疗复杂性孤立肾肾癌:3例报告并文献复习  

Robot-assisted single-port laparoscopic nephrectomy with a workbench procedure and autologous kidney transplantation for the treatment of complex renal cancer in a solitary kidney:report of three cases and literature review

作　　者：杨铖铖 倪斌 郑明 魏勇 陈星梅[1] 杨昕 朱清毅 顾民 沈百欣[1] YANG Chengcheng;NI Bin;ZHENG Ming;WEI Yong;CHEN Xingmei;YANG Xin;ZHU Qingyi;GU Min;SHEN Baixin(Department of Urology,the Second Affiliated Hospital of Nanjing Medical University,Nanjing,21001l,China)

机构地区：[1]南京医科大学第二附属医院泌尿外科,南京210011

出　　处：《临床泌尿外科杂志》2025年第3期275-279,共5页Journal of Clinical Urology

基　　金：国家自然科学基金资助项目(No:82270817);江苏省健康委医学科研项目(No:202021028)。

摘　　要：目的:探究机器人辅助单孔腹腔镜技术联合工作台手术及自体肾移植术治疗复杂性孤立肾肾癌的安全性及可行性。方法:选择2022年11月—2024年5月确诊的3例孤立肾肾癌患者进行研究,孤立肾切取术在机器人辅助单孔腹腔镜下完成,工作台手术切除肾脏肿瘤并行肾脏修补,然后将肾脏移植回患者体内。结果:3例患者手术均顺利完成,平均手术时间(501.67±40.12) min,平均热缺血时间(4.20±0.88) min,平均冷缺血时间(31.64±2.10) min,术中平均出血量(95.00±12.42) mL,术前和术后1 d、1个月平均血肌酐值分别为(69.67±5.98)μmol/L、(163.33±9.83)μmol/L、(99.73±11.38)μmol/L,术后24 h平均尿量(2 460.00±150.35) mL,平均住院时间(19.67±0.94) d,随访时间0~18个月,至末次随访所有患者肾功能稳定,无肿瘤局部复发或转移。结论:机器人辅助下单孔腹腔镜下肾切取联合工作台手术及自体肾移植术治疗孤立肾肾癌安全、有效、可行且创伤小,值得进一步探索优化。Objective:To investigate the safety and feasibility of robot-assisted single-port laparoscopic technology combined with workbench surgery and autologous kidney transplantation in the treatment of complex renal cancer in a solitary kidney.Methods:Three patients diagnosed with renal cancer in a solitary kidney between November 2022 and May 2024 were included in this study.Nephrectomy was performed using robot-assisted single-port laparoscopy,followed by tumor excision and kidney reconstruction on a workbench.The kidney was then transplanted back into the patient.Results:All three surgeries were successfully completed.The average operative time was(501.67±40.12) min,with an average warm ischemia time of(4.20±0.88) min and a cold ischemia time of(31.64±2.10) min.The mean intraoperative blood loss was(95.00±12.42) mL.The preoperative and postoperative average serum creatinine levels at 1 day and 1 month were(69.67±5.98) μmol/L,(163.33±9.83) μmol/L,and(99.73±11.38) μmol/L,respectively.The mean urine output in the first 24 hours after surgery was(2 460.00±150.35) mL,and the average hospital stay was(19.67±0.94) days.The follow-up period ranged from 0 to 18 months,and as of the last follow-up,all patients had stable renal function with no local tumor recurrence or metastasis.Conclusion:Robot-assisted single-port laparoscopic nephrectomy combined with workbench surgery and autologous kidney transplantation is a safe,effective,and minimally invasive approach to the treatment of renal cancer in a solitary kidney.This technique warrants further exploration and optimization.

关 键 词：机器人手术 单孔腹腔镜 孤立肾肾癌 工作台手术 自体肾移植 

分 类 号：R737.11[医药卫生—肿瘤]