摘要
目的:探讨机器人辅助后腹腔入路肾部分切除术联合腔内B超治疗完全内生型肾肿瘤的有效性和安全性。方法:整理2016年4月至2019年4月我院23例机器人辅助后腹腔入路肾部分切除术治疗的cT1a期完全内生型肾肿瘤患者的临床资料,将同期机器人辅助后腹腔入路肾部分切除术治疗cT1a期外生型肾肿瘤40例患者作为对照组,比较两组患者之间的手术情况、术后观察指标及随访情况。结果:两组患者中山评分(Z=313.00,P=0.024)、手术时间(Z=182.00,P<0.001)、热缺血时间(t=5.04,P<0.001)等差异有统计学意义,但术中出血量、中转肾切术例数、切缘阳性率、术后估算肾小球滤过率、伤口引流管带管时间及术后住院时间、术后并发症之间的差异无统计学意义(均P>0.05)。23例完全内生型肾肿瘤中,成功切除22例,中转肾根治性切除1例。在中位随访9个月(四分位间距:6~12月)后,患者术后均无复发。结论:机器人辅助后腹腔入路肾部分切除术联合术中腔内B超治疗完全内生型肾肿瘤安全可行,其中术中B超定位是切除肿瘤的关键。
Objective:To investigate the efficacy and safety of robotic-assisted retroperitoneal laparoscopic partial nephrectomy(RA-RLPN)combined with intracavitary ultrasound in the treatment of endophytic renal tumors.Methods:Demographic and clinical characteristics of 23 patients with cT1 a endophytic renal tumors treated by RA-RLPN in Xijing Hospital from April 2016 to April 2019 were retrospectively analyzed;another 40 patients with cT1 a exophytic renal tumors undergoing RA-RLPN were taken as the control group.Intraoperative,postoperative and follow-up features were compared between the two groups.Results:There were statistically significant differences between the two groups in Zhongshan score(Z=313.00,P=0.024),operation time(Z=182.00,P<0.001)and warm ischemia time(t=5.04,P<0.001);but there were not significant differences in intraoperative bleeding,transition to radical nephrectomy,positive margin rate,postoperative estimated glomerular filtration rate,time of drainage,postoperative length of stay and complications(P>0.05).Of the 23 cases of endophytic renal tumors,22 were successfully removed,and 1 was converted to radical nephrectomy.In the median 9-month follow-up(IQR:6-12 months),postoperative recurrence was not found.Conclusion:RA-RLPN combined with intracavitary ultrasound is effective and safe for endophytic renal tumors,in which localization via intraoperative ultrasound is important to tumor removal.
作者
高学林
郑万祥
苏醒
马帅军
张龙龙
王福利
杨晓剑
袁建林
Gao Xuelin;Zheng Wanxiang;Su Xing;Ma Shuaijun;Zhang Longlong;Wang Fuli;Yang Xiaojian;Yuan Jianlin(Department of Urology,Xijing Hospital of the Air Force Medical University,Xi'an 710032,Shaanxi,China)
出处
《肿瘤预防与治疗》
2022年第4期341-346,共6页
Journal of Cancer Control And Treatment
关键词
机器人技术
后腹腔入路
完全内生型肾肿瘤
肾部分切除术
腔内B超
Robotic surgical technology
Retroperitoneal laparoscopy
Endophytic renal tumors
Partial nephrectomy
Intracavitary ultrasound
