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机器人辅助与传统腹腔镜在腰大肌固定输尿管再植术中的应用

[Application of robotic-assisted versus conventional laparoscopy in ureteral reimplantation with psoas hitch].

作者信息

Li Dong, Wang Bao-Jun, Zhang Xu, Zhang Wei

机构信息

Departmentof Urology, Guangdong General Hospital, Guangdong Academy of Medical Science, Guangzhou 510080, China.E-mail:

出版信息

Nan Fang Yi Ke Da Xue Xue Bao. 2017 May 20;37(5):659-662. doi: 10.3969/j.issn.1673-4254.2017.05.15.

Abstract

OBJECTIVE

To compare the efficacy of robotic-assisted laparoscopic and conventional laparoscopic ureteral reimplantation with psoas hitch.

METHODS

We retrospectively analyzed the data of 10 patients undergoing robotic-assisted laparoscopic ureteral reimplantation with psoas hitch and 6 undergoing conventional laparoscopic ureteral reimplantation between June, 2013 and December, 2014 in the General Hospital of PLA. The indications, surgical techniques and outcomes of the two procedures were compared.

RESULTS

All the patients completed the laparoscopic procedures without conversion to open surgery. Robotic-assisted and conventional laparoscopic procedures were comparable in terms of the mean operation time (165.50=52.57 vs 152.50=73.60 min), mean volume of blood loss (81.00=69.35 vs 46.67=31.41 mL), mean duration of catheter retention (6.75=1.74 vs 7.50=2.43 days), and mean postoperative hospital stay (7.10=2.08 vs 8.67=3.14 days). The patients were followed up for a mean of 13.5 months, during which none of the patients experienced anastomotic leak, vesicoureteral reflux or hydronephrosis.

CONCLUSION

There are no significant differences in surgical indications, surgical techniques or postoperative effect between robotic-assisted and conventional laparoscopic procedures of ureteral reimplantation with psoas hitch, but robotic-assisted laparoscopy can reduced the complexity in operation and increase the surgical precision in patients with a history of pelvic surgery, pelvic adhesion or secondary reimplantation.

摘要

目的

比较机器人辅助腹腔镜与传统腹腔镜联合腰大肌悬吊输尿管再植术的疗效。

方法

回顾性分析2013年6月至2014年12月期间解放军总医院10例行机器人辅助腹腔镜联合腰大肌悬吊输尿管再植术患者及6例行传统腹腔镜输尿管再植术患者的数据。比较两种手术的适应证、手术技术及手术效果。

结果

所有患者均顺利完成腹腔镜手术,无一例中转开放手术。机器人辅助腹腔镜手术与传统腹腔镜手术在平均手术时间(165.50±52.57 vs 152.50±73.60分钟)、平均失血量(81.00±69.35 vs 46.67±31.41毫升)、平均留置导尿管时间(6.75±1.74 vs 7.50±2.43天)及平均术后住院时间(7.10±2.08 vs 8.67±3.14天)方面相当。患者平均随访13.5个月,期间无一例发生吻合口漏、膀胱输尿管反流或肾积水。

结论

机器人辅助腹腔镜与传统腹腔镜联合腰大肌悬吊输尿管再植术在手术适应证、手术技术及术后效果方面无显著差异,但机器人辅助腹腔镜手术可降低盆腔手术史、盆腔粘连或二次再植患者的手术复杂性并提高手术精度。

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