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目的:总结我院机器人辅助腹腔镜保留肾单位肾部分切除术的手术经验,探讨此术式疗效及安全性。方法:2007年12月～2008年10月,对6例肾肿瘤患者行达·芬奇机器人(Da Vinci机器人手术系统)辅助腹腔镜保留肾单位肾部分切除术,将相关资料与国外此手术初期资料及我院同组人员腹腔镜保留肾单位肾部分切除术的资料进行比较分析。结果:6例患者中,1例改行开放性保留肾单位肾部分切除术,其余5例手术均成功。手术时间(不包括术前机器人准备时间) 130(110～160)min,肾动脉阻断时间40(33～50)min,术中出血量188(100～380)ml。术后7天下床活动,3天拔除引流管,术后住院9(8～12)天,肾功能均在正常范围。术后病理检查提示为肾透明细胞癌5例,乳头状癌1例,无一例切缘阳性。随访4～15个月,全部患者未见局部病灶残留、局部复发、切口种植及远处转移。结论:机器人辅助腹腔镜保留肾单位肾部分切除术是一种创伤小、安全可靠、疗效确切的手术方法。随着操作熟练程度的提高,此术式优势将更加明显。
OBJECTIVE: To summarize the surgical experience of nephron-assisted partial nephrectomy with robotic-assisted laparoscopy in our hospital to investigate the efficacy and safety of this technique. METHODS: From December 2007 to October 2008, a nephrectomy was performed on laparoscopic nephrectomy in Da Vinci robotic system with Da Vinci robotic system in 6 patients with renal tumors. The relevant data were compared with those in other foreign countries Data and our hospital with the same group of patients laparoscopic nephron nephrectomy retained the data for comparative analysis. Results: Of the 6 patients, 1 patient underwent partial nephron partial nephrectomy while the remaining 5 patients were successful. The operative time (excluding preoperative robot preparation time) was 130 (110-160) min, the renal artery occlusion time was 40 (33-50) min, and the intraoperative blood loss was 188 (100-380) ml. Get out of bed 7 days after surgery, drainage tube drainage 3 days, postoperative hospital 9 (8 ~ 12) days, renal function are in the normal range. Postoperative pathological examination prompted renal clear cell carcinoma in 5 cases, 1 case of papillary carcinoma, no case of positive margins. All cases were followed up for 4 ~ 15 months. No local lesions, local recurrence, incision implantation and distant metastasis were found in all the patients. Conclusion: The robot assisted laparoscopic nephron nephrectomy is a less invasive, safe and reliable surgical method with definite curative effect. With the improvement of proficiency in operation, the advantage of this technique will be more obvious.