Department of Robotic Urological Surgery, Abano Terme Hospital, Abano Terme, Italy.
Department of Urology, University of Bologna, Bologna, Italy.
Int Braz J Urol. 2018 Jan-Feb;44(1):63-68. doi: 10.1590/S1677-5538.IBJU.2017.0104.
The aim of our study is to present early outcomes of our series of retroperitoneal-RAPN (Robot Assisted Partial Nephrectomy).
From September 2010 until December 2015, we performed 81 RAPN procedures (44 at left kidney and 37 at right). Average size was 3cm (1-9). Average PADUA score 7.1 (5-10). Average surgical time (overall and only robot time), ischemia time, blood loss, pathological stage, complications and hospital stay have been recorded.
All of the cases were completed successfully without any operative complication or surgical conversion. Average surgical time was 177 minutes (75-340). Operative time was 145 minutes (80-300), overall blood loss was 142cc (60-310cc). In 30 cases the pedicle was late clamped with an average ischemia time of 4 minutes (2-7). None of the patient had positive surgical margins at definitive histology (49pT1a, 12pT1b, 3pT2a, 2pT3a). Hospital stay was 3 days (2-7).
The retroperitoneal robotic partial nephrectomy approach is safe and allows treatment of even quite complex tumors. It also combines the already well known advantages guaranteed by the da Vinci® robotic surgical system, with the advantages of the retroperitoneoscopic approach.
我们研究的目的是展示后腹腔镜 - RAPN（机器人辅助部分肾切除术）系列的早期结果。
从 2010 年 9 月至 2015 年 12 月，我们进行了 81 例 RAPN 手术（左肾 44 例，右肾 37 例）。平均肿瘤大小为 3cm（1-9）。平均 PADUA 评分 7.1（5-10）。记录了平均手术时间（总时间和仅机器人时间）、缺血时间、出血量、病理分期、并发症和住院时间。
所有病例均成功完成，无任何手术并发症或手术转换。平均手术时间为 177 分钟（75-340）。手术时间为 145 分钟（80-300），总出血量为 142cc（60-310cc）。在 30 例病例中，采用晚期夹闭肾蒂，平均缺血时间为 4 分钟（2-7）。所有病例在最终组织学检查中均未发现阳性切缘（49 例 pT1a，12 例 pT1b，3 例 pT2a，2 例 pT3a）。住院时间为 3 天（2-7）。
后腹腔镜机器人辅助部分肾切除术是安全的，适用于治疗即使是相当复杂的肿瘤。它还结合了达芬奇®机器人手术系统已有的优点，以及后腹腔镜入路的优点。
