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目的:总结机器人辅助腹腔镜下行大体积肾肿瘤切除术的手术经验,探讨该技术的疗效及安全性。方法:回顾性分析2014年10月~2016年12月采用机器人辅助腹腔镜完成大体积肾肿瘤切除术21例患者的临床资料,总结巨大肾肿瘤的临床特点及该类手术的经验。结果:21例手术均顺利完成,无中转开放及脏器损伤病例,术中无输血,无术中并发症发生。患者年龄45~80岁,平均63岁;手术时间90~240 min,平均(150.3±30.0)min;术中出血60~800ml,平均(100.5±10.5)ml;肠道功能恢复时间1~4d,平均(1.5±0.5)d;引流管拔除时间1~3d,平均(1.5±0.5)d;住院时间3~5d,平均(4.5±0.5)d。术后病理提示:肾透明细胞癌18例,肾错构瘤3例。随访1~22个月,无肿瘤复发或远处转移发生。结论:机器人辅助腹腔镜大体积肾肿瘤切除术安全可行,远期肿瘤学效果需大宗病例的长期随访研究证实。
OBJECTIVE: To summarize the surgical experience of robotic assisted laparoscopic radical mass nephrectomy and to explore the efficacy and safety of this technique. Methods: The clinical data of 21 patients who undergone massive laparoscopic nephrectomy with robotic laparoscopy from October 2014 to December 2016 were retrospectively analyzed. The clinical features and the experience of such surgery were summarized. Results: All the 21 cases were successfully completed. There were no cases of transfusion and organ injury. No intraoperative blood transfusion and no intraoperative complications occurred. The patients were 45 to 80 years old with an average of 63 years old. The operative time ranged from 90 to 240 minutes (mean, 150.3 ± 30.0) min. The intraoperative bleeding ranged from 60 to 800 ml, with an average of (100.5 ± 10.5) (1.5 ± 0.5) days. The time of drainage tube drainage was 1 ~ 3d, with an average of 1.5 ± 0.5 days. The length of hospital stay was 3 ~ 5 days, with an average of 4.5 ± 0.5 days. Postoperative pathology prompted: renal clear cell carcinoma in 18 cases, renal hamartoma in 3 cases. Followed up for 1 ~ 22 months, no tumor recurrence or distant metastasis occurred. Conclusion: Robot assisted laparoscopic resection of large volume renal tumors is safe and feasible. The long-term follow-up study of long-term oncology results needs to be confirmed.