中华泌尿外科杂志
中華泌尿外科雜誌
중화비뇨외과잡지
CHINESE JOURNAL OF UROLOGY
2012年
11期
814-817
,共4页
王林辉%叶华茂%徐斌%刘冰%纪家涛%肖亮%盛夏%王利丽%程欣%侯炯%侯建国%孙颖浩
王林輝%葉華茂%徐斌%劉冰%紀傢濤%肖亮%盛夏%王利麗%程訢%侯炯%侯建國%孫穎浩
왕림휘%협화무%서빈%류빙%기가도%초량%성하%왕리려%정흔%후형%후건국%손영호
机器人%外科手术,微创性%腹腔镜检查%肾部分切除术
機器人%外科手術,微創性%腹腔鏡檢查%腎部分切除術
궤기인%외과수술,미창성%복강경검사%신부분절제술
Robotics%Surgical procedures,minimally invasive%Laparoscopy%Partial nephrectomy
目的 总结机器人辅助腹腔镜下肾部分切除术的手术经验,探讨该术式的疗效及安全性. 方法 2012年3-7月实施机器人辅助腹腔镜下肾部分切除术12例.患者均为男性.年龄43 ～66岁,平均55岁.肿瘤位于左肾4例,右肾8例；背侧7例,腹侧2例；上极3例,中部5例,下极4例.术前常规行肾GFR检查均正常.CT检查肿瘤最大径2.0～5.8 cm,平均3.3 cm.术前分期均为T1N0M0. 结果 本组手术均成功完成,无中转开放手术者.手术时间160 ～ 310 min,平均242 min；术中失血量30 ～300 ml,平均135 ml,无术中输血；热缺血时间20 ～49 min,平均31 min；无术中并发症.住院天数9～31 d,平均14d.1例术后1周出现肉眼血尿.术后病理检查11例为肾透明细胞癌,Furhman分级均为Ⅱ级,1例为肾血管平滑肌脂肪瘤.肿瘤最大径2.0～5.0 cm,平均3.5 cm,肿瘤切缘均为阴性. 结论 机器人辅助腹腔镜下肾部分切除术是一种安全、有效的治疗局限性肾肿瘤的术式.该术式在肾肿瘤的完整切除及肾脏创面的缝合上有明显的优势.
目的 總結機器人輔助腹腔鏡下腎部分切除術的手術經驗,探討該術式的療效及安全性. 方法 2012年3-7月實施機器人輔助腹腔鏡下腎部分切除術12例.患者均為男性.年齡43 ～66歲,平均55歲.腫瘤位于左腎4例,右腎8例；揹側7例,腹側2例；上極3例,中部5例,下極4例.術前常規行腎GFR檢查均正常.CT檢查腫瘤最大徑2.0～5.8 cm,平均3.3 cm.術前分期均為T1N0M0. 結果 本組手術均成功完成,無中轉開放手術者.手術時間160 ～ 310 min,平均242 min；術中失血量30 ～300 ml,平均135 ml,無術中輸血；熱缺血時間20 ～49 min,平均31 min；無術中併髮癥.住院天數9～31 d,平均14d.1例術後1週齣現肉眼血尿.術後病理檢查11例為腎透明細胞癌,Furhman分級均為Ⅱ級,1例為腎血管平滑肌脂肪瘤.腫瘤最大徑2.0～5.0 cm,平均3.5 cm,腫瘤切緣均為陰性. 結論 機器人輔助腹腔鏡下腎部分切除術是一種安全、有效的治療跼限性腎腫瘤的術式.該術式在腎腫瘤的完整切除及腎髒創麵的縫閤上有明顯的優勢.
목적 총결궤기인보조복강경하신부분절제술적수술경험,탐토해술식적료효급안전성. 방법 2012년3-7월실시궤기인보조복강경하신부분절제술12례.환자균위남성.년령43 ～66세,평균55세.종류위우좌신4례,우신8례；배측7례,복측2례；상겁3례,중부5례,하겁4례.술전상규행신GFR검사균정상.CT검사종류최대경2.0～5.8 cm,평균3.3 cm.술전분기균위T1N0M0. 결과 본조수술균성공완성,무중전개방수술자.수술시간160 ～ 310 min,평균242 min；술중실혈량30 ～300 ml,평균135 ml,무술중수혈；열결혈시간20 ～49 min,평균31 min；무술중병발증.주원천수9～31 d,평균14d.1례술후1주출현육안혈뇨.술후병리검사11례위신투명세포암,Furhman분급균위Ⅱ급,1례위신혈관평활기지방류.종류최대경2.0～5.0 cm,평균3.5 cm,종류절연균위음성. 결론 궤기인보조복강경하신부분절제술시일충안전、유효적치료국한성신종류적술식.해술식재신종류적완정절제급신장창면적봉합상유명현적우세.
Objective To summarize the surgical experience in robotic-assisted laparoscopic partial nephrectomy,and to investigate the efficacy and safety of this surgery.Methods The clinical data of 12 patients who underwent robot-assisted laparoscopic partial nephrectomy in Changhai Hospital from March to July in 2012 were analyzed.All the patients were male and the age range was 43-66 years.In 4 cases the tumors were in the left kidney,and 8 in the right.In 7 cases the tumors were in the dorsal part of the kidney,and 2 in the ventral part.There were 3,5 and 4 cases in the upper,middle and lower pole of the kidney respectively.Preoperative GFR test was normal in all cases.Kidney CT scan showed the maximum diameters of the tumors were 2.0-5.8 cm,with an average of 3.3 cm.The pre-operative stages in all cases were T1N0M0.Results The surgery was successfully completed in all cases.The mean duration of the surgery was 160-310 min,with an average of 242 min.The blood loss was 30-300 ml,with an average of 135 ml,and the intraoperative blood transfusion was unnecessary.The warm ischemia time was 20-49 min,with an average of 31 min.There was no intraoperative morbidity,and no conversion to open surgery.The postoperative length of hospitalization was 9-31 d,with an average of 14 d.Gross hematuria arose in 1 patient at 1 week after the surgery.The post-operative pathology showed renal clear cell carcinoma with Furhman Grade Ⅱ in 11 cases,and renal angiomyolipoma in 1 case.The maximum diameters of the tumors were 2.0-5.0 cm,with an average of 3.5 cm.The tumor resection margin was negative in all cases.Conclusions Robot-assisted laparoscopic partial nephrectomy is safe and effective for local renal tumors.This surgery has significant advantage over traditional laparoscopic partial nephrectomy,in terms of the resection of the renal tumors and the reconstruction of the kidney.
