Robot-assisted retroperitoneal partial nephrectomy for partial nephrectomy: an analysis of 118 cases

Siji SONG; Peng HE; Ji ZHENG; Zhipeng CHEN; Yang LIU; Yongquan WANG; Jinhong PAN

doi:10.16016/j.1000-5404.201810118

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Robot-assisted retroperitoneal partial nephrectomy for partial nephrectomy: an analysis of 118 cases

Clinical Medicine | 更新时间：2026-01-09

- Robot-assisted retroperitoneal partial nephrectomy for partial nephrectomy: an analysis of 118 cases
- Journal of Third Military Medical University Vol. 41, Issue 7, Pages: 696-700(2019)
- 作者机构：
  
  400038 重庆，陆军军医大学(第三军医大学)第一附属医院泌尿外科
- 作者简介：
- 基金信息：
  
  the General Program of Natural Science Foundation of Chongqing(CSTC2018jcyjA1984)
- DOI：10.16016/j.1000-5404.201810118
  CLC： R181.32;R699.2;R737.11
- Received：24 October 2018，
  
  Revised：2019-01-03，
  
  Published：15 April 2019
- 稿件说明：
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Siji SONG, Peng HE, Ji ZHENG, et al. Robot-assisted retroperitoneal partial nephrectomy for partial nephrectomy: an analysis of 118 cases[J]. Journal of Third Military Medical University, 2019, 41(7): 696-700.
DOI：

Siji SONG, Peng HE, Ji ZHENG, et al. Robot-assisted retroperitoneal partial nephrectomy for partial nephrectomy: an analysis of 118 cases[J]. Journal of Third Military Medical University, 2019, 41(7): 696-700. DOI： 10.16016/j.1000-5404.201810118.

摘要

目的

分析机器人辅助下经后腹腔入路行肾部分切除术(robot-assisted retroperitoneal partial nephrectomy，RARPN)的患者资料，探讨该术式的手术操作要点及优势。

方法

回顾性分析2011年6月至2018年6月本科完成的RARPN患者118例的临床资料，分别对年龄、体质量指数(BMI)、R.E.N.A.L.评分、手术时间、热缺血时间、出血量、住院时间、术后并发症以及术后随访情况等进行分析。

结果

118例患者均成功完成手术，其手术时间为(127.6±34.5)min，热缺血时间为(19.8±5.1)min，出血

量为(97.3±67.3)mL，术后引流管拔除时间为(2.7±0.6)d，术后肠道通气时间为(1.9±0.7)d，住院时间为(6.0±0.9)d。肿瘤分期为T

患者的手术时间、热缺血时间短于T

患者(

0.05)；BMI＜24 kg/m

的患者手术时间优于BMI≥24 kg/m

患者(

0.05)。术后仅1例(0.8%)发生并发症。随访3个月至5年，有1例复发并出现肺转移。

结论

经后腹腔入路为肾部分切除术良好适应证，对于T

的肿瘤尤其适用；对于肥胖患者(BMI＞24 kg/m

)在清除肾周脂肪后也能很好地完成手术。

Abstract

Objective

To analyze the clinical data of the patients undergoing robot-assisted retroperitoneal partial nephrectomy (RARPN) and investigate the surgical points and advantages of the surgery.

Methods

Clinical data of 118 patients undergoing RARPN in our department from June 2011 to June 2018 were collected and retrospectively analyzed in this study. Their age

body mass index (BMI)

R.E.N.A.L. score

operation time

warm ischemia time

amount of blood loss

length of hospital stay

postoperative complications

and data during follow-up were analyzed statistically.

Results

The operation was successfully completed in all 118 patients. The operation time was 127.6±34.5 min

warm ischemia time 19.8±5.1 min

amount of bleeding 97.3±67.3 mL

postoperative drainage time 2.7±0.6 d

intestinal exhaust time 1.9±0.7 d

and length of hospital stay 6.0±0.9 d. The operation time and warm ischemia time were significantly shorter in T

stage patients than T

stage patients (

0.05). The operation time was obviously shorter in the BMI

24 kg/m

group than those with BMI≥24 kg/m

(

0.05). Only 1 case (0.8%) experienced postoperative complication. During follow-up of 3 months to 5 years

pulmonary metastasis occurred in 1 patient.

Conclusion

The retroperitoneal approach is a good indication for partial nephrectomy

and T

age tumor is a good indication for RARPN. For obese patients (BMI

24 kg/m

)

removal of perinephric fat is also a good way to complete the surgery.

关键词

Keywords

references

CHEN W, ZHENG R, BAADE P D, et al. Cancer statistics in China, 2015[J]. Ca Cancer J Clin, 2016, 66(2):115-132.DOI: 10.3322/caac.21338.

WINFIELD H N, DONOVAN J F, GODET A S, et al. Laparoscopic partial nephrectomy: initial case report for benign disease[J]. J Endourol, 1993, 7(6): 521-526. DOI:10.1089/end.1993.7.521.

GETTMAN M T, BLUTE M L, CHOW G K, et al. Robotic-assisted laparoscopic partial nephrectomy: technique and initial clinical experience with DaVinci robotic system[J]. Urology, 2004, 64(5): 914-918. DOI:10.1016/j.urology.2004.06.049.

PATTON M W, SALEVITZ D A, TYSON M D ND, et al. Robot-assisted partial nephrectomy for complex renal masses[J]. J Robot Surg, 2016, 10(1): 27-31. DOI:10.1007/s11701-015-0554-8.

CHOI J E, YOU J H, KIM D K, et al. Comparison of perioperative outcomes between robotic and laparoscopic partial nephrectomy: a systematic review and meta-analysis[J]. Eur Urol, 2015, 67(5): 891-901. DOI:10.1016/j.eururo.2014.12.028.

PAK J S, LEE J J, BILAL K, et al. Utilization trends and outcomes up to 3 months of open, laparoscopic, and robotic partial nephrectomy[J]. J Robot Surg, 2017, 11(2): 223-229. DOI:10.1007/s11701-016-0650-4.

高宇, 张旭.机器人肾部分切除术的应用现状和研究进展[J].微创泌尿外科杂志, 2016, 5(1):56-62.DOI:10.3969/j.issn.2095-5146.2016.01.016.

GAO Y, ZHANG X. Current status and research progress of robotic partial nephrectomy[J]. J Minim Invas Urol, 2016, 5(1): 56-62. DOI:10.19558/j.cnki.10-1020/r.2016.01.016.

MIYAKE H, FURUKAWA J, HINATA N, et al. Significant impact of R.E.N.A.L. nephrometry score on changes in postoperative renal function early after robot-assisted partial nephrectomy[J]. Int J Clin Oncol, 2015, 20(3): 586-592. DOI:10.1007/s10147-014-0751-x.

LUCIANI L G, CHIODINI S, DONNER D, et al. Early impact of robot-assisted partial nephrectomy on renal function as assessed by renal scintigraphy[J]. J Robot Surg, 2016, 10(2): 123-128. DOI:10.1007/s11701-016-0576-x.

MIYAKE H, HINATA N, IMAI S, et al. Partial nephrectomy for hilar tumors: comparison of conventional open and robot-assisted approaches[J]. Int J Clin Oncol, 2015, 20(4): 808-813. DOI:10.1007/s10147-015-0783-x.

GHANI K R, PORTER J, MENON M, et al. Robotic retroperitoneal partial nephrectomy: a step-by-stepguide[J]. BJU Int, 2014, 114(2):311-313.DOI:10.1111/bju.12709.

GARISTO J, BERTOLO R, DAGENAIS J, et al. Robotic versus open partial nephrectomy for highly complex renal masses:comparisonof perioperative, functional, and oncological outcomes[J]. Urol Oncol, 2018, 36(10):471.e1-471.e9. DOI: 10.1016/j.urolonc.2018.06.012.

李新涛, 张旭, 吕香君.后腹腔入路机器人肾部分切除术:手术效果与技术现状[J].微创泌尿外科杂志, 2016, 5(2): 124-128. DOI:10.19558/j.cnki.10-1020/r.2016.02.018.

LI X T, ZHANG X, LYU X J. Robot-assisted retroperitoneal partial nephrectomy: summary on technical experience and operation efficacy[J]. J Minim Invas Urol, 2016, 5(2): 124-128. DOI:10.19558/j.cnki.10-1020/r.2016.02.018.

吕香君, 张旭, 马鑫, 等.经后腹腔入路机器人肾部分切除术手术经验和临床疗效总结(附单中心189例病例报道)[J].微创泌尿外科杂志, 2016, 5(2): 65-68. DOI:10.19558/j.cnki.10-1020/r.2016.02.001.

LYU X J, ZHANG X, MA X, et al. Clinical experience and efficacies of retroperitoneal robotic partial nephrectomy: a single center reports with 189 cases[J]. J Minim Invas Urol, 2016, 5(2): 65-68. DOI:10.19558/j.cnki.10-1020/r.2016.02.001.

THOMPSON R H, LANE B R, LOHSE C M, et al. Every minute counts when the renal hilum is clamped during partial nephrectomy[J]. Eur Urol, 2010, 58(3): 340-345. DOI:10.1016/j.eururo.2010.05.047.

MAURICE M J, KAOUK J H, RAMIREZ D, et al. Robotic partial nephrectomy for posterior tumors through a retroperitoneal approach offers decreased length of stay compared with the transperitoneal approach: a propensity-matched analysis[J]. J Endourol, 2017, 31(2): 158-162. DOI:10.1089/end.2016.0603.

SHIROKI R, FUKAMI N, FUKAYA K, et al. Robot-assisted partial nephrectomy: superiority over laparoscopic partial nephrectomy[J]. Int J Urol, 2016, 23(2): 122-131. DOI:10.1111/iju.13001.

LJUNGBERG B, BENSALAH K, CANFIELD S, et al. EAU guidelines on renal cell carcinoma: 2014 update[J]. Eur Urol, 2015, 67(5): 913-924. DOI:10.1016/j.eururo.2015.01.005.

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