论文部分内容阅读
目的:汇报我院650例机器人手术的治疗结果,总结其临床经验。方法:我院于2010年3月~2015年10月共行达芬奇机器人辅助腹腔镜泌尿外科手术650例,其中上尿路手术484例,包括肾上腺切除术183例,根治性肾切除术46例,肾部分切除术130例,肾输尿管全长切除术13例,上尿路切开取石及上尿路成形术93例,马蹄肾峡部离断术1例,多囊肾去顶17例,腹膜后淋巴结清扫1例。下尿路手术166例,其中根治性前列腺切除术122例,根治性膀胱切除术25例,膀胱部分切除术11例,前列腺剜除术4例,脐尿管囊肿切除术3例,膀胱阴道瘘修补1例。结果:上尿路手术中,1例肾上腺手术因术中机械故障中转开放手术;另1例因术后继发性出血,二次开放手术止血。所有下尿路手术均获得成功。结论:泌尿外科的绝大部分手术适应机器人辅助腹腔镜手术,尤其适合肾盂输尿管成形术、肾部分切除术、根治性前列腺切除术和根治性膀胱切除术。对于大体积的肾上腺切除术、大体积的单纯前列腺剜除术以及保留神经的腹膜后淋巴结清扫术也有优势。相对于上尿路手术,下尿路手术的优势更为明显。
Objective: To report the results of 650 robotic surgery in our hospital and summarize its clinical experience. Methods: From March 2010 to October 2015, our hospital consisted of 650 Da Vinci robot-assisted laparoscopic urological operations, including 484 cases of upper urinary tract surgery, including 183 cases of adrenalectomy and radical nephrectomy Cases, partial nephrectomy in 130 cases, total nephroureterectomy in 13 cases, upper urinary incision and upper urinary tract angioplasty in 93 cases, horseshoe kidney isthmus off in 1 case, polycystic kidney to the top in 17 cases, Retroperitoneal lymph node dissection in 1 case. Lower urinary tract surgery in 166 cases, of which 122 cases of radical prostatectomy, radical cystectomy in 25 cases, partial resection of the bladder in 11 cases, prostate gastrectomy in 4 cases, uvula cyst excision in 3 cases, vesicovaginal fistula Repair 1 case. Results: In the upper urinary tract surgery, one case of adrenal surgery was switched to open surgery due to intraoperative mechanical failure; the other was due to secondary hemorrhage after operation. The second open surgery was used to stop bleeding. All lower urinary tract surgery were successful. CONCLUSIONS: The vast majority of urologic surgeries are adapted to robotic-assisted laparoscopic surgery and are particularly suitable for ureteropelvic transurethral resection, radical prostatectomy and radical cystectomy. Large volume of adrenalectomy, bulky simple prostatectomy, and nerve-preserving retroperitoneal lymph node dissection also have advantages. Relative to the upper urinary tract surgery, the advantages of lower urinary tract surgery is more obvious.