Kim Dae Keun, Komninos Christos, Kim Lawrence, Rha Koon Ho
Department of Urology, Urological Science Institute, College of Medicine, Yonsei University, Yonseiro 50-1, Seodaemun-gu, Seoul, 120-752, South Korea.
Center of Minimally Invasive Urological Surgery, Medical Center, Athens, Greece.
Curr Urol Rep. 2015 Nov;16(11):76. doi: 10.1007/s11934-015-0552-4.
Robot-assisted partial nephrectomy (RAPN) has gained increasing popularity in the management of renal masses due to its technical feasibility and shorter learning curve with superior perioperative outcomes compared to laparoscopic partial nephrectomy (LPN). Given the cumulation of surgical experience on RAPN, the indication for RAPN has been extended to more challenging, complex cases, such as hilar or endophytic tumors. Renal masses that are completely endophytic can be very challenging to surgeons. These cases are associated with poor recognition of mass extension, higher risk of inadvertent vascular, or pelvicalyceal system injury. As a result, this can lead to potential positive surgical margin, difficulty in performing renorrhaphy as well as higher perioperative complication rates. There is few evidence of oncologic and functional outcomes of RAPN on treating endophytic masses. Therefore, the objective of this review is to critically analyze the current evidence and to provide a summary on the outcomes of RAPN for endophytic renal masses.
机器人辅助部分肾切除术（RAPN）因其技术可行性、学习曲线短以及与腹腔镜部分肾切除术（LPN）相比具有更好的围手术期结果，在肾肿块的治疗中越来越受到欢迎。随着RAPN手术经验的积累，其适应证已扩展到更具挑战性的复杂病例，如肾门或内生性肿瘤。完全内生性的肾肿块对外科医生来说可能极具挑战性。这些病例存在对肿块扩展认识不足、意外血管或肾盂肾盏系统损伤风险较高的问题。因此，这可能导致手术切缘阳性、肾缝合困难以及围手术期并发症发生率较高。关于RAPN治疗内生性肿块的肿瘤学和功能结果的证据很少。因此，本综述的目的是批判性地分析当前证据，并总结RAPN治疗内生性肾肿块的结果。
