應(yīng)用第四臂提升經(jīng)后腹腔機(jī)器人輔助腹腔鏡腎部分切除術(shù)治療T1b期腎腫瘤的療效

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Efficacy of using the fourth arm in retroperitoneal robot-assisted partial nephrectomy for cT1b stage renal tumors

CHEN Shaojun，PAN Xiuwu，YE Jianqing，ZHANG Liang，CUI Xingang

（Department of Urology，Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine，Shanghai 200092，China）

ABSTRACT：Objective To investigate the efficacy and safety of using the fourth arm in retroperitoneal robot-assisted partial nephrectomy （PN） for cT1b stage renal tumors.Methods Clinical data of 49 patients with cT1b stage renal tumors who underwent retroperitoneal robot-assisted PN performed by the same surgeon in our hospital during Jan.2022 and Dec.2023 were retrospectively analyzed.The patients were divided into two groups based on whether the fourth arm was used or not：application group （n=21） and non-application group （n=28）.The basic information，operation time，warm ischemia time，intraoperative blood loss，postoperative complications and other data were compared between the two groups.Results All operations were successful，with no conversion to open surgery or radical nephrectomy.The application group had significantly shorter operation time [（128.76±31.58） min vs.（151.11±33.21） min，P=0.021]，shorter warm ischemia time [（24.67±4.80） min vs.（27.61±3.54） min，P=0.017]，and less intraoperative blood loss [（109.05±39.99） mL vs.（139.29±54.43） mL，P=0.037] compared with the non-application group.The increase of postoperative creatinine was （18.64±16.05） μmol/L in the application group and （20.30±13.49） μmol/L in the non-application group respectively.Complications occurred in 3 cases in the application group and 5 cases in the non-application group，with no significant difference（P＞0.05）.Conclusion When we perform the retroperitoneal robot-assisted partial nephrectomy for cT1b stage renal tumors，using the fourth arm can shorten the operation time and warm ischemia time，and reduce the intraoperative blood loss，which should be applied more in clinic.

KEY WORDS：renal tumor; partial nephrectomy; robot-assisted; the fourth arm; retroperitoneal approach

摘要：目的 探討在經(jīng)后腹腔機(jī)器人輔助腹腔鏡腎部分切除術(shù)（PN）治療T1b期腎腫瘤中應(yīng)用第四臂的療效和安全性。（剩余8365字）