CAJ | 학술논문

目的：：总结经后腹腔途径行机器人辅助腹腔镜与传统腹腔镜下手术切术肾肿瘤的手术治疗经验,探讨机器人辅助腹腔镜的疗效及优势.方法：2012年5月~2013年8月,收治3例肾肿瘤患者进行机器人辅助腹腔镜下肾部分切除术(RALPN),同期选取3例行传统腹腔镜下手术切术(LPN)肾肿瘤的患者资料进行分析.结果：6例手术均取得成功.其中RALPN术3例手术时间(不包括术前机器人准备时间)110~180 min(平均145 min),出血量50~100 ml,术后2~3天拔除引流管,3天左右下床活动,术后住院时间8~10天.术后2周复查未见局部病灶残留,肾功能与术前无明显变化.3例行LPN术手术时间为120~200 min(平均160 min),出血量80~150 ml,术后3~4天拔除引流管,4~5天下床活动,术后住院时间9~12天.术后2周复查未见局部病灶残留,肾功能与术前无明显变化.结论：RALPN在手术出血及术后患者恢复等方面与LPN相比更具一定优势,手术效率更高,操作灵活,创伤小,疗效确切.
목적：：총결경후복강도경행궤기인보조복강경여전통복강경하수술절술신종류적수술치료경험,탐토궤기인보조복강경적료효급우세.방법：2012년5월~2013년8월,수치3례신종류환자진행궤기인보조복강경하신부분절제술(RALPN),동기선취3례행전통복강경하수술절술(LPN)신종류적환자자료진행분석.결과：6례수술균취득성공.기중RALPN술3례수술시간(불포괄술전궤기인준비시간)110~180 min(평균145 min),출혈량50~100 ml,술후2~3천발제인류관,3천좌우하상활동,술후주원시간8~10천.술후2주복사미견국부병조잔류,신공능여술전무명현변화.3례행LPN술수술시간위120~200 min(평균160 min),출혈량80~150 ml,술후3~4천발제인류관,4~5천하상활동,술후주원시간9~12천.술후2주복사미견국부병조잔류,신공능여술전무명현변화.결론：RALPN재수술출혈급술후환자회복등방면여LPN상비경구일정우세,수술효솔경고,조작령활,창상소,료효학절.
Objective:To compare the treatment experience between conventional laparoscopy with robot-assisted laparosco-py (da Vinci Si System)for partial nephrectomy through retroperitoneal approach,and discuss curative effect and advantages of robotic system.Methods:Between May 2012 and August 2013,3 patients with renal tumor were performed robotic-assisted la-proscopic partial nephrectomy(RALPN).During the same period,3 patients with renal tumor were performed conventional lap-aroscopic partial nephrectomy(LPN).Results:All procedures were performed successfully.The operative time for RALPN was 110-180 minutes (mean 145 minutes);blood loss was 50-100 mL,drain removal time was 2-3 days.The hospital stay was 8-10 days with 3 days of immobilization.Radiological examination found no local residual tumor,and the postoperative serum creati-nine level was norma1 two weeks after operation.The operative time for conventional LPN was 120-200 minutes (mean 160 mi-nutes);blood loss was 80-150 mL,drain removal time was 3-4 days.The hospital stay was 9-12 days with 4-5 days of immobi-lization.Radiological examination found no local residual tumor,and the postoperative serum creatinine level was norma1 two weeks after operation.Conclusions:RALPN through retroperitoneal approach could reduce the suturing time and blood loss and has the merits of small wound and early recovery than conventional LPN.