Abstract：Objective： To explore the effect of MR technology on the clinical efficacy of robotic surgery for complex renal tumors. Methods： From June 2018 to June 2019, a total of 50 patients with complex renal tumors diagnosed by CT or MRI were randomly divided into two groups: MR assisted group and traditional robotic operation group. The data of perioperative related indexes, postoperative complications and pathological results were compared between the two groups. T-test and chi square test were used in statistical method, nonparametric test is used for the selection of measurement data that does not meet the homogeneity of normal distribution variance. Results： There was no significant difference between two groups in the proportion of surgeons ,baseline data, drainage within 24 hours after operation, the proportion of creatinine rise on the first day after operation, the length of hospital stays and fasting days after operation (P > 0.05), but there was significant difference between the two groups in the amount of bleeding, operation time and WIT (P < 0.05). Conclusion： Compared with the traditional robot surgery, MR assisted robotic surgery can shorten the operation time and WIT, reduce the amount of bleeding during operation, and help the operator to make better operation strategy. On the basis of not increasing the incidence of complications and hospital stays, MR assisted robotic surgery can reserve more renal function, which is going to used widely in clinical practice.
杨阳, 朱捷, 高宇, 张鹏, 黄庆波, 杨罗佳, 沈诞, 宋勇, 符伟军, 马鑫, 张旭. 混合现实平台影像辅助技术对复杂性肾肿瘤机器人肾部分切除术临床疗效的影响[J]. 微创泌尿外科杂志, 2020, 9(2): 73-77.
YANG Yang, ZHU Jie, GAO Yu, ZHANG Peng, HUANG Qingbo, YANG Luojia, SHEN Dan, SONG Yong, FU Weijun, MA Xin, ZHANG Xu. Effect of mixed reality-assisted robotic surgery on the treatment of complex renal tumors. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2020, 9(2): 73-77.
[1] JEMAL DA, SIEGEL MR, WARD DE, et al.Cancer statistics. CA Cancer J Clin, 2007,57(1):43-66.
[2] MURAMAKI M, MIYAKE H, SAKAI I, et al.Prognostic factors influencing postoperative development of chronic kidney disease in patients with small renal tumors who underwent partial nephrectomy. Curr Urol, 2012,6(3):129-135.
[3] 那彦群,叶章群,孙颖浩,等.中国泌尿外科疾病诊断治疗指南(2014版).北京:人民卫生出版社,2014:184-185.
[4] RAHEEM AA, ALATAWI A, KIM DK, et al.Outcomes of high complex renal tumor (PADUA≥10) following robot-assisted partial nephrectomy with a median of 46 months follow-up: A tertiary center experience. BJU Int, 2016,118(5):770-778.
[5] 章小平,蒋国松.复杂性肾肿瘤治疗方法选择及保留肾单位手术的应用.临床泌尿外科杂志,2019,34(1):1-5.
[6] COHEN JJ.Digital medicine: the promise and the peril. Mayo Clin Proc, 2001,76(8):857-859.
[7] 朱捷,沈诞,刘启明,等.混合现实平台远程协作机器人微创手术1例报告.微创泌尿外科杂志,2018,7(4):278-281.
[8] SIMON PK, THOMPSON RH, BOORJIAN SA, et al.Comparative effectiveness for survival and renal function of partial and radical nephrectomy for localized renal tumors: a systematic review and Meta-Analysis. J Urol, 2012,188(1):51-57.
[9] 张雪培,任选义.复杂性肾脏肿瘤开放手术保留肾单位的技术探讨(附光盘).现代泌尿外科杂志,2015,20(3):141-143.
[10] BURAK T, ARON M, INDERBIR SG.Expanding indications for laparoscopic partial nephrectomy. Urology, 2008,72(3):481-487.
[11] GOPAL NG, PETERSON J, KAILASH NT, et al.Oncological outcomes of partial nephrectomy for multifocal renal cell carcinoma greater than 4 cm. J Urol, 2010,184(1):59-63.
[12] STEINBERG AP, METE K, SIDNEY CA, et al.Laparoscopic nephron-sparing surgery for two or more ipsilateral renal tumors. Urology, 2004,64(2):255-258.
[13] GILL IS, COLOMBO JR, FRANK I, et al. Laparoscopic partial nephrectomy for hilar tumors. J Urol, 2005,174(3):850-853; discussion 853-854.
[14] SHAO IH, KAN HC, LIU CY, et al.Role Of Robot-Assisted Partial Nephrectomy For Renal Cell Carcinomas In The Purpose Of Nephron Sparing. Onco Targets Ther, 2019,12:8189-8196.
[15] 张凯,朱刚,李鸿波,等.三维影像重建在泌尿外科机器人手术中的应用.中华泌尿外科杂志,2018,39(9):690-693.
[16] YUAN G, KE T, JIAN S, et al.Application of mixed reality technology in visualization of medical operations. Chin Med Sci J, 2019,34(2):103-109.
[17] THOMPSON RH, LANE BR, LOHSE CM, et al.Renal function after partial nephrectomy: effect of warm ischemia relative to quantity and quality of preserved kidney. Urology, 2012,79(2):356-360.
[18] SONG C, BANG JK, PARK HK, et al. Factors influencing renal function reduction after partial nephrectomy. J Urol, 2009,181(1):48-53; discussion 53-54.
