[1]宋思吉,何鹏,郑霁,等.机器人辅助经后腹腔入路肾部分切除术118例分析[J].第三军医大学学报,2019,41(07):696-700.
 SONG Siji,HE Peng,ZHENG Ji,et al.Robot-assisted retroperitoneal partial nephrectomy for partial nephrectomy: an analysis of 118 cases [J].J Third Mil Med Univ,2019,41(07):696-700.
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机器人辅助经后腹腔入路肾部分切除术118例分析(/HTML )
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
41卷
期数:
2019年第07期
页码:
696-700
栏目:
临床医学
出版日期:
2019-04-15

文章信息/Info

Title:
Robot-assisted retroperitoneal partial nephrectomy for partial nephrectomy: an analysis of 118 cases
 
作者:
宋思吉何鹏郑霁陈志朋刘洋王永权潘进洪
陆军军医大学(第三军医大学)第一附属医院泌尿外科
 
Author(s):
SONG Siji HE Peng ZHENG Ji CHEN Zhipeng LIU Yang WANG Yongquan PAN Jinhong

Department of Urology, First Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, 400038, China

关键词:
机器人腹腔镜经后腹腔肾部分切除术肾肿瘤
Keywords:
robotics laparoscopes retroperitoneal approach partial nephrectomy kidney neoplasms
分类号:
R181.32; R699.2; R737.11
文献标志码:
A
摘要:

目的 分析机器人辅助下经后腹腔入路行肾部分切除术(robotassisted retroperitoneal partial nephrectomy,RARPN)的患者资料,探讨该术式的手术操作要点及优势。方法 回顾性分析2011年6月至2018年6月本科完成的RARPN患者118例的临床资料,分别对年龄、体质量指数(BMI)、R.E.N.A.L.评分、手术时间、热缺血时间、出血量、住院时间、术后并发症以及术后随访情况等进行分析。结果 118例患者均成功完成手术,其手术时间为(127.6±34.5)min,热缺血时间为(19.8±5.1)min,出血量为(97.3±67.3)mL,术后引流管拔除时间为(2.7±0.6)d,术后肠道通气时间为(1.9±0.7)d,住院时间为(6.0±0.9)d。肿瘤分期为T1a患者的手术时间、热缺血时间短于T1b患者(P<0.05);BMI<24 kg/m2的患者手术时间优于BMI≥24 kg/m2患者(P<0.05)。术后仅1例(0.8%)发生并发症。随访3个月至5年,有1例复发并出现肺转移。结论 经后腹腔入路为肾部分切除术良好适应证,对于T1a的肿瘤尤其适用;对于肥胖患者(BMI>24 kg/m2)在清除肾周脂肪后也能很好地完成手术.

Abstract:

Objective To analyze the clinical data of the patients undergoing robot-assisted retroperitoneal partial nephrectomy (RARPN) and investigate the surgical points and advantages of the surgery. Methods Clinical data of 118 patients undergoing RARPN in our department from June 2011 to June 2018 were collected and retrospectively analyzed in this study. Their age, body mass index (BMI), R.E.N.A.L. score, operation time, warm ischemia time, amount of blood loss, length of hospital stay, postoperative complications, and data during followup were analyzed statistically. Results The operation was successfully completed in all 118 patients. The operation time was 127.6±34.5 min, warm ischemia time 19.8±5.1 min, amount of bleeding 97.3±67.3 mL, postoperative drainage time 2.7±0.6 d, intestinal exhaust time 1.9±0.7 d, and length of hospital stay 6.0±0.9 d. The operation time and warm ischemia time were significantly shorter in T1a stage patients than T1b stage patients (P<0.05). The operation time was obviously shorter in the BMI<24 kg/m2 group than those with BMI≥24 kg/m2 (P<0.05). Only 1 case (0.8%) experienced postoperative complication. During follow-up of 3 months to 5 years, pulmonary metastasis occurred in 1 patient. Conclusion The retroperitoneal approach is a good indication for partial nephrectomy, and T1a stage tumor is a good indication for RARPN. For obese patients (BMI>24 kg/m2),  removal of perinephric fat is also a good way to complete the surgery.

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更新日期/Last Update: 2019-04-05