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目的:总结经后腹腔途径行机器人辅助腹腔镜与传统腹腔镜下手术切术肾肿瘤的手术治疗经验,探讨机器人辅助腹腔镜的疗效及优势。方法:2012年5月~2013年8月,收治3例肾肿瘤患者进行机器人辅助腹腔镜下肾部分切除术(RALPN),同期选取3例行传统腹腔镜下手术切术(LPN)肾肿瘤的患者资料进行分析。结果:6例手术均取得成功。其中RALPN术3例手术时间(不包括术前机器人准备时间)110~180min(平均145min),出血量50~100ml,术后2~3天拔除引流管,3天左右下床活动,术后住院时间8~10天。术后2周复查未见局部病灶残留,肾功能与术前无明显变化。3例行LPN术手术时间为120~200min(平均160min),出血量80~150ml,术后3~4天拔除引流管,4~5天下床活动,术后住院时间9~12天。术后2周复查未见局部病灶残留,肾功能与术前无明显变化。结论:RALPN在手术出血及术后患者恢复等方面与LPN相比更具一定优势,手术效率更高,操作灵活,创伤小,疗效确切。
OBJECTIVE: To summarize the experiences of surgical treatment of renal tumors by robot-assisted laparoscopy and conventional laparoscopic surgery via the retroperitoneal approach to explore the efficacy and advantages of robotic-assisted laparoscopy. METHODS: From May 2012 to August 2013, 3 patients with renal cancer underwent robotic laparoscopic partial nephrectomy (RALPN). Three patients underwent conventional laparoscopic surgery (LPN) for renal cell carcinoma Patient information for analysis. Results: All the 6 surgeries were successful. The operation time of RALPN in 3 cases (excluding preoperative robot preparation time) was 110 ~ 180min (average 145min), bleeding amount was 50 ~ 100ml. The drainage tube was removed 2 ~ 3 days after operation, Time 8 to 10 days. There were no local lesions after 2 weeks of reexamination, no significant changes of renal function and preoperative. 3 routine LPN surgery time was 120 ~ 200min (average 160min), bleeding 80 ~ 150ml, 3 to 4 days after removal of the drainage tube, 4 to 5 days out of bed activities, postoperative hospital stay 9 to 12 days. There were no local lesions after 2 weeks of reexamination, no significant changes of renal function and preoperative. Conclusion: Compared with LPN, RALPN has some advantages over LPN in surgical bleeding and postoperative recovery. The operative efficiency is higher, the operation is more flexible, the trauma is smaller and the curative effect is exact.