Abstract：Objective: To summarize the clinical experience and efficacies of retroperitoneal approach robot-assisted partial nephrectomy (RPRPN). Methods: Clinical data of 189 patients receiving RPRPN in Chinese PLA General Hospital from December 2013 to December 2015 were retrospectively analyzed. The pre-operation preparation, manipulation of robot and the location of trocars were described. The key operative technique and procedure were shown in videos. Statistical analysis was performed about age, BMI, maximum tumor diameter, tumor site, intraoperative estimated blood loss, warm ischemia time, operatinon time, postoperative tumor margins and complications. Results: All the operations were successfully performed without conversion to open surgery. The mean operative time was (76.13±2.79)(60-105) min. The mean estimated blood loss was (61.14±8.51) (10-130)mL. The mean warm ischemia time was (15.24±0.62) (9-31) min. The mean postoperative drainage time was (4.49±0.26) (1-6) min. The mean postoperative hospital stay was (6.13±0.13) (4-7) days. Pathological results confirmed 161 clear cell renal cell carcinomas, 12 angioleiomyolipomas, 7 multilocular cystic renal cell carcinomas, 5 papilarry cacinomas, 2 chromophobe renal carcinomas, and two other pathological types. No positive margin was found and 9 cases were converted to radical nephrectomy. Six cases received transfusion for greater than 400 mL blood loss. The postoperative complications included severe renal dysfunction in three cases, atrial fibrillation in two cases, myocardial infarction in one case, urinary leakage in one case and postoperative bleeding greater than 400 mL in five cases. One case received radical nephrectomy postoperatively. Two cases received endovascular embolization therapy and three cases had postoperative arterio-venous fistula. No deaths occurred postoperatively. One recurrence and no deaths were found within the follow-up time of 11(2-28) months. Conclusions: Retroperitoneal robotic partial nephrectomy is technically safe and feasible, which is more suitable for renal tumors located in posterior side, upper pole, and posterior hilum of the kidney.
吕香君, 张旭, 马鑫, 李宏召, 李新涛, 艾青, 刘启明, 黄双. 经后腹腔入路机器人肾部分切除术手术经验和临床疗效总结(附单中心189例病例报道)[J]. 微创泌尿外科杂志, 2016, 0(2012～2016 机器人选集(1)): 30-33.
Lyu Xiangjun, Zhang Xu, Ma Xin, Li Hongzhao, Li Xintao, Ai Qing, Liu Qiming, Huang Shuang. Clinical experience and efficacies of retroperitoneal robotic partial nephrectomy: a single center reports with 189 cases. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2016, 0(2012～2016 机器人选集(1)): 30-33.
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