Ener Kemal, Altınova Serkan, Canda Abdullah Erdem, Özcan Muhammet Fuat, Asil Erem, Ürer Emre, Atmaca Ali Fuat, Akbulut Ziya
Department of Urology, Ankara Atatürk Training and Research Hospital, Ankara, Turkey.
Department of Urology, Yıldırım Beyazıt University Faculty of Medicine, Ankara Atatürk Training and Research Hospital, Ankara, Turkey.
Turk J Urol. 2014 Dec;40(4):193-8. doi: 10.5152/tud.2014.33898.
We evaluated outcomes of our robot-assisted laparoscopic transperitoneal pyeloplasty (RALP) procedures.
Between July 2011 and March 2014, 18 RALP procedures were performed at our instutition. Ureteropelvic junction obstruction (UPJO) diagnosis was made based on clinical presentation and intravenous urography. All patients underwent basal and diuretic isotopic renography to evaluate the degree of obstruction and impaired renal function. Anderson-Hynes dismembered pyeloplasty technique was used with a transperitoneal approach by using the da Vinci-S 4-arm surgical robot. Outcomes were assessed retrospectively.
Mean patient age was 31.3±11.7 (13-62) years. Male: female ratio was 9: 9. All procedures were primary surgeries. Of 18 patients, 10 (55.5%) had a crossing vessel and 8 (44.5%) had intrinsic obstruction. Mean operative time was 150.4±17.2 (115-185) minutes. Mean anastomosis time was 21.4±5.5 (10-33) minutes. Mean blood loss during the operation was 33.6±17.3 (10-60) cc. Mean hospital stay was 2.6±1.0 (1-6) days. No conversion to open surgery was required. No intraoperative and perioperative (0-30 days) complication occurred. Readmission rate during perioperative period was 0%. Median follow-up was 16.6±10.3 (3-35) months. Postoperative intravenous urography and renography showed improved results in all cases.
Due to our experience, RALP is a safe and feasible minimally invasive approach in patients with UPJO with excellent surgical and functional outcomes.
我们评估了机器人辅助腹腔镜经腹膜肾盂成形术（RALP）的手术效果。
2011年7月至2014年3月期间，我们机构共进行了18例RALP手术。根据临床表现和静脉肾盂造影诊断输尿管肾盂连接部梗阻（UPJO）。所有患者均接受基础和利尿同位素肾图检查，以评估梗阻程度和肾功能受损情况。采用安德森-海因斯离断性肾盂成形术技术，通过达芬奇-S四臂手术机器人经腹膜途径进行手术。对手术效果进行回顾性评估。
患者平均年龄为31.3±11.7（13 - 62）岁。男女比例为9:9。所有手术均为初次手术。18例患者中，10例（55.5%）有交叉血管，8例（44.5%）有内在梗阻。平均手术时间为150.4±17.2（115 - 185）分钟。平均吻合时间为21.4±5.5（10 - 33）分钟。术中平均失血量为33.6±17.3（10 - 60）毫升。平均住院时间为2.6±1.0（1 - 6）天。无需转为开放手术。术中及围手术期（0 - 30天）无并发症发生。围手术期再入院率为0%。中位随访时间为16.6±10.3（3 - 35）个月。术后静脉肾盂造影和肾图检查显示所有病例结果均有改善。
根据我们的经验，RALP是治疗UPJO患者的一种安全可行的微创方法，具有良好的手术和功能效果。
