机器人肾移植术围手术期疗效分析

钟晓; 兰卫华; 王洛夫; 张尧; 张军; 聂志林; 李珂; 袁刚; 舒泽华; 童大力; 李耀明; 刘秋礼; 王鹏; 江军

doi:10.16016/j.2097-0927.202204035

您当前的位置：

首页 >

文章列表页 >

机器人肾移植术围手术期疗效分析

临床医学 | 更新时间：2026-01-09

- 机器人肾移植术围手术期疗效分析
- Efficacy of robotic renal transplantation in perioperative period
- 陆军军医大学学报 2022年44卷第18期页码：1862-1866
- 作者机构：
  
  400042 重庆，陆军特色医学中心泌尿外科
- 作者简介：
  
  [ 江军，E-mail: jiangjun_64@163.com JIANG Jun, jiangjun_64@163.com
- 基金信息：
  
  重庆市科卫联合医学科研项目(2020MSXM063);陆军军医大学临床医学科研人才培养计划(2018XLC3043)
- DOI：10.16016/j.2097-0927.202204035
  中图分类号： R616;R617;R699.2
- 收稿：2022-04-05，
  
  修回：2022-06-04，
  
  纸质出版：2022-09-30
- 稿件说明：
移动端阅览
钟晓, 兰卫华, 王洛夫, 等. 机器人肾移植术围手术期疗效分析[J]. 陆军军医大学学报, 2022,44(18):1862-1866.

Xiao ZHONG, Weihua LAN, Luofu WANG, et al. Efficacy of robotic renal transplantation in perioperative period[J]. Journal of Army Medical University, 2022, 44(18): 1862-1866.
钟晓, 兰卫华, 王洛夫, 等. 机器人肾移植术围手术期疗效分析[J]. 陆军军医大学学报, 2022,44(18):1862-1866. DOI： 10.16016/j.2097-0927.202204035.

Xiao ZHONG, Weihua LAN, Luofu WANG, et al. Efficacy of robotic renal transplantation in perioperative period[J]. Journal of Army Medical University, 2022, 44(18): 1862-1866. DOI： 10.16016/j.2097-0927.202204035.

摘要

目的

初步探讨机器人辅助腹腔镜肾移植术(robotic-assisted kidney transplantation

RAKT)围手术期的安全性及有效性。

方法

收集2018年6月至2022年3月陆军特色医学中心泌尿外科行肾移植术的14例患者资料，其中男性8例，女性6例，年龄22~45岁。采用活体供肾机器人辅助腹腔镜下肾移植术4例(RAKT组)，采用尸体供肾开放肾移植术(open kidney transplantation

OKT)10例(OKT组)。回顾性分析2组患者的动静脉吻合时间、术后住院时间、手术前后血肌酐值、术中出血量及术后并发症等。

结果

14例患者均顺利完成手术，术中出血量RAKT组为(162.5±47.8)mL，明显低于OKT组的(245.1±68.5)mL(

0.05)；RAKT组动脉吻合时间为(32.5±6.5)min，OKT组为(24.3±5.3)min；RAKT组静脉吻合时间为(16.5±3.8)min，OKT组为(14.6±1.5)min；RAKT组术后7 d血肌酐(98.1±33.2)μmol/L，OKT组为(142.8±42.1)μmol/L；引流管留置时间OKT组为(10.0±1.2) d，明显长于RAKT组的(6.5±0.5) d (

0.01)；术后住院时间RAKT组为(13.0±2.5) d，明显短于OKT组的(16.3±2.1) d (

=0.01)。

结论

初步证实RAKT围手术期安全有效，术后并发症较OKT少。

Abstract

Objective

To preliminarily investigate the safety and effectiveness of robot-assisted kidney transplantation (RAKT) in the perioperative period.

Methods

Clinical data of 14 patients undergoing renal transplantation in our department from June 2018 to March 2022 were collected and retrospectively analyzed. They were 8 males and 6 females

and at an age of 22 to 45 years. There were 4 patients receiving robotic-assisted laparoscopic living-donor kidney transplantation (RAKT group)

and 10 cases receiving open kidney transplantation (OKT group) with deceased donor kidney. Arterio-venous anastomoses (AVAs) time

length of post-operative stay

pre- and post-operative serum creatinine levels

intraoperative blood loss

and incidence of post-operative complications were retrospectively analyzed between the patients of the 2 groups.

Results

The surgeries went well in the 14 patients. The amount of intraoperative blood loss was 162.5±47.8 mL in the RAKT g

roup and 245.1±68.5 mL in the OKT group(

0.05). The arterial anastomosis time was 32.5±6.5 min in the RAKT group and 24.3±5.3 min in the OKT group. The venous anastomosis time was 16.5±3.8 min in the RAKT group and 14.6±1.5 min in the OKT group. The blood creatinine level was 98.1±33.2 μmol/L in the RAKT group and 142.8±42.1 μmol/L in the OKT group in 7 d after surgery. The retention time of drainage tube was 10.0±1.2 d in the OKT group and 6.5±0.5 d in the RAKT group(

0.01). The length of stay after surgery was 13.0±2.5 d in the RAKT group and 16.3±2.1 d in the OKT group(

=0.01).

Conclusion

RAKT is safer than OKT in the perioperative period and causes fewer postoperative complications.

关键词

Keywords

references

AUGUSTINE J. Kidney transplant: new opportunities and challenges[J]. Cleve Clin J Med, 2018, 85(2): 138-144. DOI: 10.3949/ccjm.85gr.18001.

SPIERS H V M, SHARMA V, WOYWODT A, et al . Robot-assisted kidney transplantation: an update[J ] . Clin Kidney J, 2021, 15(4): 635-643. DOI: 10.1093/ckj/sfab214.

赵鉴明, 范阳, 陈欣, 等. 机器人辅助腹腔镜同种异体肾移植术的早中期结果[J]. 微创泌尿外科杂志, 2021, 10(2): 80-83. DOI: 10.19558/j.cnki.10-1020/r.2021.02.002.

ZHAO J M, FAN Y, CHEN X, et al . Early and mid-term results of robot-assisted laparoscopic kidney transplantation[J ] . J Minim Invasive Urol, 2021, 10(2): 80-83. DOI: 10.19558/j.cnki.10-1020/r.2021.02.002.

GIULIANOTTI P, GORODNER V, SBRANA F, et al . Robotic transabdominal kidney transplantation in a morbidly obese patient[J ] . Am J Transplant, 2010, 10(6): 1478-1482. DOI: 10.1111/j.1600-6143.2010.03116.x.

AHLAWAT R, SOOD A, JEONG W, et al . Robotic kidney transplantation with regional hypothermia versus open kidney transplantation for patients with end stage renal disease: an ideal stage 2B study[J ] . J Urol, 2021, 20 5(2): 595-602. DOI: 10.1097/JU.0000000000001368.

林涛. 机器人辅助手术系统在肾移植中的应用[J]. 器官移植, 2022, 13(1): 1-5. DOI: 10.3969/j.issn.1674-7445.2022.01.001.

LIN T. Application of robot assisted surgical system in kidney transplantation[J]. Organ Transplant, 2022, 13(1): 1-5. DOI: 10.3969/j.issn.1674-7445.2022.01.001.

SPAGGIARI M, LENDACKI F R, DI BELLA C, et al . Minimally invasive, robot-assisted procedure for kidney transplantation among morbidly obese: positive outcomes at 5 years post-transplant[J ] . Clin Transplant, 2018, 32(11): e13404. DOI: 10.1111/ctr.13404.

TANGDHANAKANOND K, MANDELBROT D. Evaluation of high-risk living kidney donors[J]. Front Biosci (Elite Ed), 2015, 7(1): 158-167. DOI: 10.2741/725.

ZHONG X, HUANG C B, LI L K, et al . Endo-satinsky clamp hybrid in situ perfusion in retroperitoneoscopic donor nephrectomy for right-sided kidney[J ] . Urology, 2019, 130: 191-195. DOI: 10.1016/j.urology.2019.04.019.

DECAESTECKER K, VAN PARYS B, VAN BESIEN J, et al . Robot-assisted kidney autotransplantation: a minimally invasi ve way to salvage kidneys[J ] .Eur Urol Focus, 2018, 4(2): 198-205. DOI: 10.1016/j.euf.2018.07.019.

NELSON R J, DAGENAIS J, MAURICE M J, et al . Robotic cold ischemia achieves comparable functional outcomes to open cold ischemia during partial nephrectomy for complex kidney tumors[J ] . Urol Ann, 2018, 10(4): 386-390. DOI: 10.4103/UA.UA_91_17.

NAYA Y, KAWAUCHI A, YONEDA K, et al . A comparison of cooling methods for laparoscopic partial nephrectomy[J ] . Urology, 2008, 72(3): 687-689. DOI: 10.1016/j.urology.2007.12.043.

PRUDHOMME T, BEAUVAL J B, LESOURD M, et al . Robotic-assisted kidney transplantation in obese recipients compared to non-obese recipients: the European experience[J ] . World J Urol, 2021, 39(4): 1287-1298. DOI: 10.1007/s00345-020-03309-6.

ABAZA R, GHANI K R, SOOD A, et al . Robotic kidney transplantation with intraoperative regional hypothermia[J ] . BJU Int, 2014, 113(4): 679-681. DOI: 10.1111/bju.12572.

谭顺成, 崔建春, 宋永琳, 等. 机器人辅助腹腔镜肾移植术初步经验(附22例报告)[J]. 微创泌尿外科杂志, 2021, 10(3): 157-162. DOI: 10.19558/j.cnki.10-1020/r.2021.03.003.

TAN S C, CUI J C, SONG Y L, et al . Preliminary experience of robot-assisted laparoscopic kidney transplantation(report of 22 cases)[J ] . J Minim Invasive Urol, 2021, 10(3): 157-162. DOI: 10.19558/j.cnki.10-1020/r.2021.03.003.

SOOD A, GHANI K R, AHLAWAT R, et al . Application of the statistical process control method for prospective patient safety monitoring during the learning phase: robotic kidney transplantation with regional hypothermia (IDEAL phase 2a-b)[J ] . Eur Urol, 2014, 66(2): 371-378. DOI: 10.1016/j.eururo.2014.02.055.https://pubmed.ncbi.nlm.nih.gov/24631408/

浏览量

下载量

CSCD

文章被引用时，请邮件提醒。

提交

工具集

关联资源

机器学习驱动的个性化氨甲环酸用药推荐改善骨科手术患者围手术期预后：一项基于大样本数据库的研究

局部进展期胃癌患者新辅助化疗后围手术期的临床观察

不同浓度右美托咪定对大鼠心脏死亡后供体肾脏的影响

尸体肾移植受者术后围术期腹泻的影响因素分析

帕瑞昔布钠超前镇痛在鼻内镜局麻手术围手术期应用的临床研究