Singh Iqbal
Department of Urology, Wake Forest University Medical School and Baptist Medical Centre, Medical Centre Boulevard, Winston Salem - 27157, North Carolina, USA.
J Minim Access Surg. 2009 Oct;5(4):87-92. doi: 10.4103/0972-9941.59305.
To visit the operative technique and to review the current published English literature on the technique, and outcomes following robot-assisted laparoscopic partial nephrectomy (RPN).
We searched the published English literature and the PubMed(()) for published series of 'robotic partial nephrectomy' (RPN) using the keywords; robot, robot-assisted laparoscopic partial nephrectomy, laparoscopic partial nephrectomy, partial nephrectomy and laparoscopic surgery.
The search yielded 15 major selected series of 'robotic partial nephrectomy'; these were reviewed, tracked and analysed in order to determine the current status and role of RPN in the management of early renal neoplasm(s), as a minimally invasive surgical alternative to open partial nephrectomy. A review of the initial peri-operative outcome of the 350 cases of select series of RPN reported in published English literature revealed a mean operating time, warm ischemia time, estimated blood loss and hospital stay, of 191 minutes, 25 minutes, 162 ml and 2.95 days, respectively. The overall computed mean complication rate of RPN in the present select series was about 7.4%.
RPN is a safe, feasible and effective minimally invasive surgical alternative to laparoscopic partial nephrectomy for early stage (T(1)) renal neoplasm(s). It has acceptable initial renal functional outcomes without the increased risk of major complications in experienced hands. Prospective randomised, controlled, comparative clinical trials with laparoscopic partial nephrectomy (LPN) are the need of the day. While the initial oncological outcomes of RPN appear to be favourable, long-term data is awaited.
探讨机器人辅助腹腔镜部分肾切除术（RPN）的手术技术，回顾当前已发表的关于该技术及术后结果的英文文献。
我们使用关键词“机器人”“机器人辅助腹腔镜部分肾切除术”“腹腔镜部分肾切除术”“部分肾切除术”及“腹腔镜手术”，在已发表的英文文献及PubMed数据库中检索“机器人部分肾切除术”（RPN）的系列报道。
检索得到15个主要的“机器人部分肾切除术”系列报道；对这些报道进行回顾、追踪和分析，以确定RPN在早期肾肿瘤治疗中的现状及作用，作为开放性部分肾切除术的一种微创手术替代方法。对已发表英文文献中报道的350例RPN系列病例的初始围手术期结果进行回顾发现，平均手术时间、热缺血时间、估计失血量及住院时间分别为191分钟、25分钟、162毫升及2.95天。本系列病例中RPN的总体计算并发症发生率约为7.4%。
对于早期（T(1)）肾肿瘤患者，RPN是一种安全、可行且有效的腹腔镜部分肾切除术的微创手术替代方法。在经验丰富的医生操作下，其初始肾功能结果可接受，且不会增加严重并发症的风险。目前需要进行与腹腔镜部分肾切除术（LPN）的前瞻性随机对照比较临床试验。虽然RPN的初始肿瘤学结果似乎良好，但仍有待长期数据。
