Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, USA.
J Endourol. 2010 Mar;24(3):385-91. doi: 10.1089/end.2009.0199.
Radiofrequency ablation (RFA)-assisted laparoscopic partial nephrectomy (LPN) may allow for improved hemostasis without need for renal hilar vessel clamping and elimination of warm ischemia to the kidney. We compare outcomes in patients undergoing radiofrequency ablation-assisted robotic clampless partial nephrectomy (RF-RCPN) and LPN.
Thirty-six patients and 42 patients underwent LPN and RF-RCPN, respectively. In the RF-RCPN group, the Habib 4x RFA device was used to coagulate a margin of normal parenchyma around the renal mass to allow excision of the mass within a bloodless plane. Unlike in the LPN group, renal hilar vascular occlusion was not performed in the RF-RCPN group.
Tumors treated in the RF-RCPN group tended to be larger (2.8 vs. 2.0 cm) and more often endophytic (52.6% vs. 16.1%). Collecting system reconstruction occurred more often in the RF-RCPN group (78.6% vs. 30.6%). Operative duration was longer in the RF-RCPN group (373 vs. 250 minutes), but this included time for cystoscopy, ureteral stenting, and repositioning of the patient. Blood loss, transfusion rates, renal function, and complication rates did not differ between the two groups. No patients required renal hilar vessel clamping or nephrectomy to control bleeding in the RF-RCPN group.
The use of RFA-assistance during robotic partial nephrectomy allows excision of renal tumors without hilar vascular clamping, thus eliminating renal warm ischemia. Larger and more centrally located tumors were excised with RF-RCPN. No differences in blood loss, complication rate, postoperative bleeding, renal function, or recurrence rate were noted compared with LPN.
射频消融（RFA）辅助腹腔镜部分肾切除术（LPN）可能通过无需肾门血管夹闭来实现更好的止血，并消除肾脏热缺血。我们比较了接受射频消融辅助机器人无夹闭部分肾切除术（RF-RCPN）和 LPN 治疗的患者的结局。
36 例患者接受 LPN，42 例患者接受 RF-RCPN。在 RF-RCPN 组中，使用 Habib 4x RFA 设备凝固肾肿块周围的正常实质边缘，以在无血平面下切除肿块。与 LPN 组不同，RF-RCPN 组未进行肾门血管闭塞。
RF-RCPN 组治疗的肿瘤往往更大（2.8 厘米 vs. 2.0 厘米）且更常为内生型（52.6% vs. 16.1%）。RF-RCPN 组更常进行集合系统重建（78.6% vs. 30.6%）。RF-RCPN 组的手术时间更长（373 分钟 vs. 250 分钟），但这包括膀胱镜检查、输尿管支架置入和患者重新定位的时间。两组的失血量、输血率、肾功能和并发症发生率无差异。在 RF-RCPN 组中，没有患者需要肾门血管夹闭或肾切除术来控制出血。
在机器人部分肾切除术中使用 RFA 辅助可切除肾肿瘤而无需肾门血管夹闭，从而消除肾脏热缺血。使用 RF-RCPN 切除了更大和更中央位置的肿瘤。与 LPN 相比，RF-RCPN 组在失血量、并发症发生率、术后出血、肾功能或复发率方面无差异。
