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目的:讨论机器人辅助腹腔镜根治性肾切除术在治疗T2期肾癌的手术方法及临床经验。方法:回顾性分析2013年3月~2016年5月,应用达芬奇机器人辅助腹腔镜技术完成的26例根治性肾切除术,且根据术后病理分期为T2期肿瘤患者的临床资料。结果:26例手术全部经腹途径完成,均顺利完成。手术时间110~300 min,平均177.9 min;术中出血量40~900ml,平均222.6ml;胃肠功能恢复时间1~6d,平均3.2d;引流管拔除时间1~12d,平均4.3d;术后住院时间3~19d,平均7.1d。肿瘤最大直径7.5~17.0cm,平均11.2cm。术后随访时间3~12个月,所有患者无局部复发及远处转移。结论:机器人辅助腹腔镜根治性肾切除术治疗T2期肾癌是潜在可行的,更多的临床手术经验、长期的随访结果将对其效果进行评估,进一步大量的随机对照研究有利于这一技术的推广及应用。
Objective: To discuss the surgical methods and clinical experience of robot assisted laparoscopic radical nephrectomy in the treatment of stage T2 renal cell carcinoma. Methods: From March 2013 to May 2016, 26 radical nephrectomies completed with da Vinci robot-assisted laparoscopic technique were retrospectively analyzed. The clinical data of patients with stage T2 neoplasm according to the postoperative pathological staging were retrospectively analyzed. Results: All the 26 surgeries were completed via the abdominal route and were successfully completed. The operation time was 110-300 minutes with an average of 177.9 minutes. The intraoperative blood loss was 40-900 ml with an average of 222.6 ml. The recovery time of gastrointestinal function was 1-6 days with an average of 3.2 days. The drainage time was 1 ~ 12 days (mean 4.3 days) Hospitalization time 3 ~ 19d, an average of 7.1d. The maximum diameter of tumor 7.5 ~ 17.0cm, an average of 11.2cm. All cases were followed up for 3 to 12 months without any local recurrence and distant metastasis. Conclusions: Robotic-assisted laparoscopic radical nephrectomy for the treatment of stage T2 renal cancer is potentially viable. More clinical experience and long-term follow-up results will assess its efficacy. Further randomized controlled studies are in favor of this technique The promotion and application.