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目的总结机器人辅助腹腔镜保留肾单位肾部分切除术的手术经验,探讨此术式疗效及安全性。方法回顾分析实施机器人辅助腹腔镜下肾部分切除术4例(2例男性,2例女性)患者临床资料。结果本组手术均成功完成,无中转开放手术者。手术时间125~150 min,平均140.0 min;术中失血量30~100 m L,平均85.0 m L,无术中输血;热缺血时间12~30 min,平均21.0 min;无术中并发症。术后住院7~11 d,平均8.5 d。术后病理检查均为肾透明细胞癌,Furhman分级均为Ⅱ级,肿瘤最大径2.5~4.3 cm,平均3.1 cm,肿瘤切缘均为阴性。结论机器人辅助腹腔镜保留肾单位肾部分切除术安全可靠,疗效确切,在肾肿瘤的完整切除及肾脏创面的缝合上有明显的优势。
Objective To summarize the experience of robot assisted laparoscopy in the surgical treatment of nephron partial nephrectomy and to explore the efficacy and safety of this technique. Methods The clinical data of 4 patients (2 males and 2 females) who underwent robotic assisted laparoscopic partial nephrectomy were retrospectively analyzed. Results of this group of patients were successfully completed, no transfer of open surgery. The operation time was 125-150 min with an average of 140.0 min. The intraoperative blood loss was 30-100 m L, with an average of 85.0 m L, with no intraoperative blood transfusion. The warm ischemic time was 12-30 min (mean, 21.0 min). No intraoperative complications occurred. After hospitalization 7 to 11 days, an average of 8.5 d. Postoperative pathological examination of renal clear cell carcinoma, Furhman grade were grade Ⅱ, the largest tumor diameter 2.5 ~ 4.3 cm, an average of 3.1 cm, the tumor margin were negative. Conclusions Robot-assisted laparoscopy is safe and reliable in nephron partial nephrectomy with definite curative effect. It has obvious advantages in complete nephrectomy and suture of kidney wound.