机器人辅助腹腔镜肾部分切除术治疗PADUA评分≥10分的肾脏肿瘤 1 .DOCVIP

机器人腹腔镜PADUA评分≥10分的肾脏肿瘤 1吴震杰，2李明敏△，刘 冰，杨 庆3蔡 晨， 1吕 晨，孙颖浩王林辉* 第二军医大学长海医院泌尿外科，上海 200433 2第二军医大学长海医院科，上海 200433 3第二军医大学长海医院诊疗科，上海 200433 [基金项目]13XD1400100). Supported by the Talents Project of Shanghai Health System (XBR2011027), and the Scientific and Technological talents Project of Shanghai (13XD1400100). [作者简介]，士，住院医师E-mail: wuzhenjie17@163.com. 叶华茂，博士，yehuamao@. 李明敏, 硕士，住院医师E-mail: limingmin421@. △共同第一作者Co-first authors). *通信作者(Corresponding author). Tel: 021-, E-mail: wlhui@ [摘要] 目的机器人辅助方法2年5月至2013年9月本单位的37机器人辅助评价疗效21例，女性16例，年龄平均52.3±10.1(32-72)岁， BMI平均24.9±3.88(17.1-34.3) kg/m2，Charlson全身合并症评分(Age-weighted)平均0.5±0.84(0-3)，肿瘤侧别(左/右) 20/17，均为单发4.2±1.19(2.1-7.2) cm，肾肿瘤PADUA评分平均10.8±0.87(10-13)，术前eGFR ( estimated Glomerular Filtration Rate)平均101.2±25.58(46.6-198.7) mL/min·1.73m2。腔镜下分离肾动静脉、肾周及肿瘤后，阻断肾蒂或不阻断肾蒂结果 37手术中转，41±50.0(120-330) min，术中出血量平均185±169.9(50-1000) ml。肾脏缺血时间平均26.7±9.90(0-50) min。术后住院时间平均11.3±3.38(7-23) d。术后并发症发生率%(5/37)。病理学检查提示：手术切缘均为阴性，透明细胞癌28例，嫌色细胞癌，肾脏良性病变5.9±4.64(1-12)月，37例患者均成活，均未发现局部复发或远处转移，eGFR平均下降百分比8%，与术前相比差异有统计学意义(Z = -2.883, p = 0.004)。结论的复杂肾功能损害小控制效果需随访。 [关键词]；腹腔镜 Da Vinci Robot-assisted LaparoPartial Nephrectomy for Renal Tumors with PADUA Score of ≥10 1WU Zhen-jie△, 1YE Hua-mao△, 2LI Ming-min△, 1LIU Bing, 1YANG Qing, 3CAI Chen, 1LV Chen, 1SUN Ying-hao, 1WANG Lin-hui* 1Department of Urology, 2Department of Radiology, 3Department of Special Clinics Changhai Hospital, Second Military Medical University, Shanghai 200433, China Corresponding author: WANG Lin-hui, Email: wlhui@ [Abstract] Objective To evaluate the safety, feasibility and efficacy of da Vinci robot-assisted laparoscopic partial nephrectomy in the treatment of renal tumors with PADUA score of ≥10, and assess its clinical role. Methods Between May 2012 and September 2013, 37 cases of da Vinci robot-assisted laparoscopic partial nephrectomy for renal tumors with PADUA score of ≥10 were performed a single urologist at our institution. Patient age 52.3?g0.1(32-72)ye