单机位机器人辅助腹腔镜下肾盂癌根治术治疗肾盂肿瘤的效果观察

目的 评估单机位机器人辅助腹腔镜下肾盂癌根治术治疗肾盂肿瘤的临床疗效及安全性.方法 回顾性分析2014年9月-2018年9月浙江省人民医院收治的42例肾盂肿瘤患者病例资料.其中男性27例,女性15例,均采用达芬奇机器人Si系统辅助腹腔镜下肾盂癌根治术.观察孔位于腹正中线患侧旁开6～8 cm平脐位置,1号臂、2号臂分别于...

Clinical observation of single-docking robot-assisted laparoscopic radical nephroureterectomy for renal pelvic carcinoma

Objective To evaluate the clinical efficacy and safety of single-docking technique for robot-assisted laparoscopic radical nephroureterectomy in the treatment of renal pelvic carcinoma.Methods Total 42 consecutive patients with renal pelvic carcinoma were enrolled for the retrospective study in our hospital from September 2014 to September 2018.There were 27 male and 15 female patients.All patients were underwent Da Vinci Si robot-assisted laparoscopic radical nephroureterectomy.The robotic camera port was placed in the affected side 6-8 cm beside the abdominal midline at the level of the umbilicus.The No.1 robotic port and the No.2 robotic port were respectively located parallel to the abdominal midline and 8 cm from the camera port.They were symmetrically distributed to the camera port line.The operative time,perioperative blood loss and postoperative complications were recorded.All patients were followed up for 12-48 months,and tumour recurrence was recorded.Results All operations were successfully completed,without transition to laparoscopic or open surgery.The blood loss was 90(50,260)mL,the operating time was 140(100,205)min,and the postoperative hospital stay was 8(6,12)days.Postoperative pathology confirmed renal pelvic malignant tumours,16 cases of gradeⅠ,17 cases of gradeⅡ,4 cases of gradeⅢand 5 cases of gradeⅣ.In 15 patients(35.7%),lymphadenectomy was performed with mean lymph node count of 14(4,24),and 5 patients were positive for lymph nodes.Postoperative complication rate:the incidence rate of Clavien grade 2 was 9.5%(2 patients required blood transfusion,2 other patients with lung infections required anti-infective treatment),Clavien grade 3 complications occurred in 4.8%of patients(2 patients underwent thoracic drainage because of pleural effusion).The incidence of complications was generally low.The median follow-up time was 16.5 months.During the follow-up period,3 patients had intravesical tumour recurrence and transurethral resection of bladder tumour.Conclusion Single-docking technique for robot-assisted laparoscopic radical nephroureterectomy is a safe and effective minimally invasive procedure with the advantages of larger operation space and more convenient operation for the treatment of renal pelvic carcinoma.