Cole Renee, Semerjian Alice
Department of Urology, University of Michigan, Ann Arbor, MI.
Department of Urology, University of Michigan, Ann Arbor, MI.
Urol Oncol. 2025 Aug;43(8):461-466. doi: 10.1016/j.urolonc.2025.01.019. Epub 2025 Feb 25.
Robotic assisted partial nephrectomy is an effective and minimally invasive approach that has gained significant popularity in the past 20 years. Guidelines support prioritizing partial nephrectomy in small renal masses when technically feasible, given improvement in long term renal function and cardiovascular risk. Increasing surgeon comfort with the robotic platform has allowed for the removal of larger and more complex tumors. There are a vast number of surgical techniques described in the literature for dissection, hilum clamping, tumor resection and renorrhaphy. We aim to describe and summarize different considerations and techniques to utilize when performing robotic assisted partial nephrectomy in complex renal masses. In this review, we specifically focus on masses with higher tumor complexity (RENAL score ≥10, those that involve or about the hilum or are invasive into the renal sinus).
机器人辅助部分肾切除术是一种有效且微创的方法，在过去20年中已获得广泛普及。鉴于长期肾功能和心血管风险有所改善，指南支持在技术可行的情况下，对小肾肿块优先进行部分肾切除术。外科医生对机器人平台的操作越来越熟练，使得更大、更复杂的肿瘤得以切除。文献中描述了大量用于解剖、肾门阻断、肿瘤切除和肾缝合的手术技术。我们旨在描述和总结在对复杂肾肿块进行机器人辅助部分肾切除术时应考虑的不同因素和使用的技术。在本综述中，我们特别关注肿瘤复杂性较高的肿块（RENAL评分≥10，累及或靠近肾门或侵入肾窦的肿块）。
