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上尿路的机器人重建

Robotic reconstruction of the upper urinary tract.

作者信息

Mufarrij Patrick W, Shah Ojas D, Berger Aaron D, Stifelman Michael D

机构信息

Department of Urology, New York University Medical Center, New York, New York, USA.

出版信息

J Urol. 2007 Nov;178(5):2002-5. doi: 10.1016/j.juro.2007.07.018. Epub 2007 Sep 17.

Abstract

PURPOSE

Reconstructive surgery of the upper urinary tract can be complicated. During the last 2 decades minimally invasive techniques have emerged as viable options for these complex procedures. We reviewed our experience with robotic surgery for upper urinary tract reconstruction.

MATERIALS AND METHODS

Between May 2002 and December 2006, a single surgeon performed certain robotic reconstructions on the upper urinary tract in 26 males and 37 females (65 renal units), including dismembered pyeloplasty, dismembered pyeloplasty with stone extraction, ureteroureterostomy, ureterolysis with omental wrap, ureterocalicostomy, ureteral reimplantation and upper pole nephroureterectomy. We compared demographic, preoperative, intraoperative and postoperative data on patients undergoing these various procedures.

RESULTS

Across all cases mean blood loss was 125 cc, mean operative time was 244.8 minutes and mean length of stay was 2.8 days. The rate of radiographic and symptomatic improvement was 97.3% and 100%, respectively. We observed 2 major complications during a mean followup of 18.7 months.

CONCLUSIONS

Our data illustrate that robotics can be successfully and safely used for virtually any type of upper urinary tract reconstruction. Robotic techniques are a viable option for upper urinary tract reconstruction.

摘要

目的

上尿路重建手术可能会很复杂。在过去20年中,微创技术已成为这些复杂手术的可行选择。我们回顾了我们在机器人手术用于上尿路重建方面的经验。

材料与方法

2002年5月至2006年12月期间,一名外科医生对26名男性和37名女性(65个肾单位)进行了某些机器人辅助的上尿路重建手术,包括离断性肾盂成形术、离断性肾盂成形术联合取石术、输尿管输尿管吻合术、带网膜包裹的输尿管松解术、输尿管肾盂造口术、输尿管再植术和上极肾输尿管切除术。我们比较了接受这些不同手术的患者的人口统计学、术前、术中和术后数据。

结果

在所有病例中,平均失血量为125毫升,平均手术时间为244.8分钟,平均住院时间为2.8天。影像学和症状改善率分别为97.3%和100%。在平均18.7个月的随访期间,我们观察到2例主要并发症。

结论

我们的数据表明,机器人技术几乎可成功且安全地用于任何类型的上尿路重建。机器人技术是上尿路重建的一种可行选择。

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