Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan; Division of Surgical Critical Care, Department of Critical Care Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan.
Asian J Surg. 2018 Mar;41(2):187-191. doi: 10.1016/j.asjsur.2016.11.003. Epub 2016 Dec 7.
BACKGROUND/OBJECTIVE: To present the long-term result and efficacy of robotic partial nephrectomy (RPN) for renal angiomyolipomas (AMLs) with perioperative outcome and renal function preservation.
From September 2006 to October 2014, the database of a single medical center was reviewed and patients who underwent RPN for AMLs were enrolled. The patient demographics, perioperative complications, and postoperative outcomes were analyzed.
We identified 23 patients who were treated with RPN for renal AMLs. The average age was 52.7 (± 9.9) years, and 20 (87%) patients were female. The median size of the resected AML was 5.2 [interquartile range (IQR)=3.1-6.8] cm. The median estimated blood loss was 100 (IQR=50-225) mL, and three (13%) patients required blood transfusion. Perioperative complications occurred in six (26%) patients and none of them are higher than Clavien Grade II. The median estimated glomerular filtration rate at 3-month and the latest follow-ups were 103 (IQR=85.5-112) mL/min/1.73m and 104 (IQR=90-112) mL/min/1.73m, respectively, with a median of 89.6% (IQR=84.2-100) and 86.9% (IQR=81.3-97.8) preservation, respectively. The median follow-up period was 40 (IQR=30.5-61.5) months. None of the patients developed complications requiring a second intervention or local recurrence of AML.
A long-term follow-up of RPN for renal AMLs revealed good preservation of renal function with a low complication rate. It may be considered as a reliable method to manage renal AMLs.
背景/目的：介绍机器人辅助部分肾切除术（RPN）治疗肾血管平滑肌脂肪瘤（AML）的长期疗效和安全性，评估围手术期结局和肾功能保护情况。
回顾单中心数据库，纳入 2006 年 9 月至 2014 年 10 月接受 RPN 治疗的 AML 患者。分析患者的人口统计学资料、围手术期并发症和术后结果。
共纳入 23 例接受 RPN 治疗的 AML 患者，平均年龄为 52.7（±9.9）岁，20 例（87%）为女性。切除的 AML 平均大小为 5.2[四分位距（IQR）=3.1-6.8]cm。中位估计失血量为 100（IQR=50-225）ml，3 例（13%）需要输血。6 例（26%）患者发生围手术期并发症，均未达到 Clavien Ⅱ级以上。术后 3 个月和最近随访时的中位估算肾小球滤过率分别为 103（IQR=85.5-112）ml/min/1.73m2和 104（IQR=90-112）ml/min/1.73m2，分别为 89.6%（IQR=84.2-100）和 86.9%（IQR=81.3-97.8），中位随访时间为 40（IQR=30.5-61.5）个月。无患者发生需要二次干预或 AML 局部复发的并发症。
长期随访 RPN 治疗肾 AML 显示出良好的肾功能保护，并发症发生率低。它可能是一种可靠的治疗肾 AML 的方法。
