机器人手术助手对后腹腔入路机器人肾部分切除术围手术期的影响

摘要

Objective:To compare the patients'perioperative outcomes and evaluate the impact of different ro-botic assistants in retroperitoneal robot-assisted partial nephrectomy (RPRPN)by single surgeon.Methods:We retrospectively analyzed the clinical features and perioperative outcomes of 5 9 patients who underwent retroperito-neal robot-assisted partial nephrectomy (RPRPN)by single surgeon and different assistants in the Department of Urology,PLA General Hospital from June 2015 to July 2016.Age,gender,BMI,preoperative serum creatinine level,comobidities,abdominal operation history,RENAL score,PADUA score as well as operation time,esti-mated blood loss,warm ischemia time,postoperative drainage,fasting time,complications,length of indwelling drainage,postoperative hospital stay and the postoperative serum creatinine levels were recorded and analyzed.Re-sults:The baseline of patients in different assistants was similar.The difference in operation time and length of in-dwelling drainage between different assistants was statistically significant (P=0.0324 and P=0.0016).Howev-er,the difference in the other perioperative outcomes was not statistically significant.Conclusions:Robotic assis-tant played an important role in the RPRPN,and different assistant surgeon had some impact on the operative time and length of indwelling drainage,but had little impact on other indicators.%目的：：比较同一主刀医生，不同手术助手对接受后腹腔入路机器人肾部分切除术(RPRPN)患者围手术期结局的影响.方法：回顾性分析2015年6月~2016年7月由同一主刀医生，不同助手完成的后腹腔入路机器人肾部分切除手术59例患者的临床资料和围手术期结局.对患者的人口学特征和术前相关指标(年龄、性别、体质指数、术前肌酐、合并症病例数、有腹部手术史病例数、RENAL评分、PADUA评分)以及术中及术后相关指标(手术时间、肾脏热缺血时间、术中估计出血量、术后第1天引流量、术后拔管时间、术后进食时间、术后住院时间、术后肌酐值以及术中及术后并发症)进行了统计学分析.结果：不同助手的病例人口学指标和术前指标差异无统计学意义.手术时间(P＝0.0324)和术后拔管时间(P＝0.0016)差异有统计学意义，热缺血时间、估计出血量、术后第1天引流量、术后进食时间、术后住院时间、术后肌酐值、并发症均差异无统计学意义(P＞0.05).结论：后腹腔入路机器人肾部分切除术依赖助手的密切配合，助手对于手术时间及术后引流时间有一定影响，但对于其他围手术期相关指标影响不大.