Abstract：Objective: To discuss the treatment and clinical experience of robot-assisted laparoscopic partial nephrectomy for renal hilar tumors. Methods: The clinical data of 740 cases receiving robot-assisted laparoscopic partial nephrectomy (RALPN) by 301st General Hospital from 2013 to 2016 were retrospectively reviewed. There were 65 cases of renal hilar tumors, including left and right hilar tumors of 39 and 26 (1.5∶1), respectively. The tumors were located on the front lip in 36 cases and the rear lip in 23 cases, and there were 6 cases of complete endophytic renal tumors. Results: All operations were completed successfully. The mean operative time was 137 (range: 60-270) min, estimated blood loss was 64 (10-1 500) mL, warm ischemic time was 24.3 (10-118) min, and postoperative tube removal time was 3 (1-21) days. Pathologically, there were 51 cases of clear cell renal cell carcinoma (Furman nuclear grade Ⅰ-Ⅲ level), 3 cases of papillary renal cell carcinoma, 7 cases of angioleiomyolipoma, 2 cases of cystic renal cell carcinoma, 1 case of oncocytoma, and 1 case of renal adenocarcinoma. Surgical margins were negative for malignancy in all cases. During a follow-up period of 1 to 96 months, there were no metastasis, deaths, recurrence, and leakage, etc. Conclusions: Robot-assisted laparoscopic partial nephrectomy for renal hilar tumor is a safe and effective operation.
[1]Reisiger K, Venkatesh R, Figenshau RS, et al. Complex laparoscopic partial nephrectomy for renal hilar tumors. Urology, 2005,65(5):888-891. [2]Khalifeh A, Autorino R, Hillyer SP, et al. Comparative outcomes and assessment of trifecta in 500 robotic and laparoscopic partial nephrectomy cases: a single surgeon experience. J Urol, 2013,189(4):1236-1242. [3]Motzer RJ, Jonasch E, Agarwal N, et al. Kidney cancer, version 3.2015. J Natl Compr Canc Netw, 2015,13(2):151-159. [4]Gill IS, Kavoussi LR, Lane BR, et al. Comparison of 1,800 laparoscopic and open partial nephrectomies for single renal tumors. J Urol, 2007,178(1):41-46. [5]Shikanov S, Lifshitz DA, Deklaj T, et al. Laparoscopic partial nephrectomy for technically challenging tumours. BJU Int, 2010,106(1):91-94. [6]Pugin F, Bucher P, Morel P. History of robotic surgery: from AESOP(R) and ZEUS(R) to da Vinci(R). J Visc Surg, 2011,148(5 Suppl):e3-e8. [7]Gettman MT, Blute ML, Chow GK, et al. Robot-assisted laparoscopic partial nephrectomy: technique and initial clinical experience with DaVinci robotic system. Urology, 2004,64(5):914-918. [8]Rogers CG, Singh A, Blatt AM, et al. Robotic partial nephrectomy for complex renal tumors: surgical technique. Eur Urol, 2008,53(3):514-521. [9]Eyraud R, Long JA, Snow-Lisy D, et al. Robot-assisted partial nephrectomy for hilar tumors: perioperative outcomes. Urology, 2013,81(6):1246-1251. [10]叶华茂,王蓉,吴震杰,等.机器人辅助腹腔镜肾部分切除术治疗PADUA评分≥10分的肾脏肿瘤.第二军医大学学报,2014,35(7):800-803. [11]Benway BM, Bhayani SB, Rogers CG, et al. Robot assisted partial nephrectomy versus laparoscopic partial nephrectomy for renal tumors: a multi-institutional analysis of perioperative outcomes. J Urol, 2009,182(3):866-872. [12]Dulabon LM, Kaouk JH, Haber GP, et al. Multi-institutional analysis of robotic partial nephrectomy for hilar versus nonhilar lesions in 446 consecutive cases. Eur Urol, 2011,59(3):325-330. [13]Abreu AL, Gill IS, Desai MM. Zero-ischaemia robotic partial nephrectomy (RPN) for hilar tumours. BJU Int, 2011,108(6 Pt 2):948-954.
