CAJ | 학술논문

目的：比较机器人辅助经腹腹腔镜肾部分切除术（ RALPN）与后腹腔镜下肾部分切除术（ RLPN）治疗早期肾癌的疗效和安全性，探讨RALPN的临床应用价值。方法选取2010年5月至2013年10月收治的70例肾癌患者，根据术式的不同分为RALPN组（ n＝36）和RLPN组（ n＝34）。比较两组手术时间、肾动脉阻断时间、术中出血量、术中输血率、术后住院时间及术后并发症发生情况。结果除RLPN组有2例术中转开放手术，两组均成功完成手术。 RALPN组和RLPN组的手术时间、肾动脉阻断时间、术中出血量、术后住院时间分别为（90．5±12．6）min和（110．7±20．3）min、（15．2±5．8）min和（24．6±7．2）min、（50．2±9．5）ml和（130．2±22．4）ml、（6．1±1．7）d和（7．8±2．2）d，两组比较差异均有统计学意义（P＜0．05）。 RALPN组和RLPN组的术中输血率分别为0和11．8％。 RALPN组术后出现1例肾周血肿，RLPN组出现1例尿漏和2例继发性出血。两组在随访期间均为无瘤生存。结论 RALPN是治疗肾癌安全、有效的微创术式。
목적：비교궤기인보조경복복강경신부분절제술（ RALPN）여후복강경하신부분절제술（ RLPN）치료조기신암적료효화안전성，탐토RALPN적림상응용개치。방법선취2010년5월지2013년10월수치적70례신암환자，근거술식적불동분위RALPN조（ n＝36）화RLPN조（ n＝34）。비교량조수술시간、신동맥조단시간、술중출혈량、술중수혈솔、술후주원시간급술후병발증발생정황。결과제RLPN조유2례술중전개방수술，량조균성공완성수술。 RALPN조화RLPN조적수술시간、신동맥조단시간、술중출혈량、술후주원시간분별위（90．5±12．6）min화（110．7±20．3）min、（15．2±5．8）min화（24．6±7．2）min、（50．2±9．5）ml화（130．2±22．4）ml、（6．1±1．7）d화（7．8±2．2）d，량조비교차이균유통계학의의（P＜0．05）。 RALPN조화RLPN조적술중수혈솔분별위0화11．8％。 RALPN조술후출현1례신주혈종，RLPN조출현1례뇨루화2례계발성출혈。량조재수방기간균위무류생존。결론 RALPN시치료신암안전、유효적미창술식。
Objective To compare the efficacy and safety between the robotic-assisted transperitoneal laparoscopic partial ne-phrectomy( RALPN) and retroperitoneal laparoscopic partial nephrectomy( RLPN) in treating early renal carcinoma. Methods Retro-spective review of 70 renal carcinoma patients from May 2010 to October 2013 was conducted. Thirty-six patients were performed with RALPN( RALPN group) , and 34 patients underwent RLPN( RLPN group) . The operation time, renal artery clamping time, intraoper-ative blood transfusion, blood loss, postoperative hospital stay and post-operative complications between the two groups were observed and compared. Results Both the two groups were performed successfully, and 2 cases intraoperatively convered to open surgery in RLPN group. The operation time, renal artery clamping time, blood loss and postoperative hospital stay of RALPN and RLPN group were(90. 5±12. 6)min and(110. 7±20. 3)min,(15. 2±5. 8)min and(24. 6±7. 2)min,(50. 2±9. 5)ml and(130. 2±22. 4)ml, (6. 1± 1. 7)d and (7. 8±2. 2)d. There were significant differences between the two groups (P<0. 05). The intraoperative blood transfusion between RALPN group and RLPN group were 0 and 11. 8%. In RALPN group, perirenal hematoma post-operation was found in one case, and in RLPN group, one case of urine leakage and 2 cases of secondary hemorrhage were found post-operation. All patients were of turmor-free survival. Conclusion RALPN is a quite effective, safe and minimally invasive surgical management for renal carcinoma with less post-operative complications.