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目的:比较同一主刀医生,不同手术助手对接受后腹腔入路机器人肾部分切除术(RPRPN)患者围手术期结局的影响。方法:回顾性分析2015年6月~2016年7月由同一主刀医生,不同助手完成的后腹腔入路机器人肾部分切除手术59例患者的临床资料和围手术期结局。对患者的人口学特征和术前相关指标(年龄、性别、体质指数、术前肌酐、合并症病例数、有腹部手术史病例数、RENAL评分、PADUA评分)以及术中及术后相关指标(手术时间、肾脏热缺血时间、术中估计出血量、术后第1天引流量、术后拔管时间、术后进食时间、术后住院时间、术后肌酐值以及术中及术后并发症)进行了统计学分析。结果:不同助手的病例人口学指标和术前指标差异无统计学意义。手术时间(P=0.032 4)和术后拔管时间(P=0.001 6)差异有统计学意义,热缺血时间、估计出血量、术后第1天引流量、术后进食时间、术后住院时间、术后肌酐值、并发症均差异无统计学意义(P>0.05)。结论:后腹腔入路机器人肾部分切除术依赖助手的密切配合,助手对于手术时间及术后引流时间有一定影响,但对于其他围手术期相关指标影响不大。
OBJECTIVE: To compare the effects of the same chief surgeon and different surgical assistants on perioperative outcomes in patients undergoing partial abdominal peritoneal robot partial nephrectomy (RPRPN). Methods: The clinical data and perioperative outcomes of 59 patients undergoing partial nephrectomy by a retroperitoneal approach robot from June 2015 to July 2016 were retrospectively analyzed. The demographic characteristics, preoperative correlations (age, sex, body mass index, preoperative creatinine, number of complications, number of cases with abdominal surgery, RENAL score, PADUA score) and intraoperative and postoperative related indicators Operation time, renal warm ischemia time, intraoperative blood loss, drainage on the first postoperative day, postoperative extubation time, postoperative eating time, postoperative hospital stay, postoperative creatinine and intraoperative and postoperative complications Disease) were analyzed statistically. Results: There was no significant difference in case-based and pre-operative indexes between different assistant’s. The difference was statistically significant between the operation time (P = 0.032 4) and postoperative extubation time (P = 0.001 6). The time of warm ischemia, the estimated bleeding amount, the amount of drainage on the first postoperative day, the time of postoperative feeding, The length of hospital stay, postoperative creatinine, and complications were not significantly different (P> 0.05). CONCLUSION: The partial nephrectomy of the posterior abdominal approach robot relies on the close cooperation of assistants. The assistants have certain influence on the operation time and postoperative drainage time, but have little effect on other perioperative related indicators.