| objectiveDa Vinci surgical system assisted laparoscopic resection with simple laparoscopic resection of the short-term effect and the advantages and disadvantages of the Da Vinci surgical system assisted laparoscopic partial nephrectomy clinical application value.MethodRetrospective analysis the clinical data of 35 patients with renal tumors admitted in General Hospital of Jinan Military from January 2011 to-December 2016.The criteria for preoperative imaging diagnosis,preoperative serum creatinine was determined by the assessment of renal function,tumor showed exophytic growth and is confined to the kidney,according to TNM stage T1aN0M0 renal cell carcinoma,clinical stage I.Among them,23 cases of suspected renal tumor due to color Doppler ultrasound examination in the body,further strengthening CT or MRI prompted renal cancer,confined to the renal membrane,the largest diameter 4cm,located in the lower kidney,no metastasis occurs.One of 12 patients with mild low back pain or hematuria,a further examination prompted renal cancer.The same cancer confined to the kidney,the maximum diameter of 4cm ",located in the renal inferior,without metastasis.According to the different surgical methods,it was divided into two groups,simple laparoscopic group of 20 cases,Da Vinci surgical group of 15 cases.Da Vinci group,10 men,women,aged 42-62 years,with an average of between the ages of.The tumor size was 2-4cm,with an average of 3.15 cm.In the general laparoscopic group,there were 10 males and females with a mean age of 45-60 years(range of 2-4cm)with an average of(range of 2.95cm).The operation time,warm ischemia time,intraoperative blood loss,postoperative complications,postoperative fluid drainage,drainage time,postoperative exhaust time and hospital stay were compared between the two groups.The data were analyzed by SPSS 20 software.The measurement data were expressed by mean square deviation,and t test was used for comparison between groups..ResultAll operations were successful.Da Vinci group,the average operation time was(124.6 + 21.2)min,the average amount of bleeding was(140 + 14.6)ML,Renal warm ischemia time 18.4±2.06 min,postoperative drainage volume average(43.2 + 11.5)ML,postoperative exhaust time averaged(47.3+14.9)h,duration of hospitalization was 7 days,1 cases of acid poisoning after surgery,patients were given oxygen,blood gas analysis in patients with normal hours to check correct is poisoning treatment and postoperative 6.The common postoperative patients with the average operation time was(152.2+21.6)min,the average amount of bleeding was(248+29.6)ML,Renal warm ischemia time 26.8±2.0min postoperative drainage volume average(72.5+14.9)ML,postoperative exhaust time averaged(80.6+6.7)h,the hospital for 14 days.Postoperative 2 cases of acidosis,given patients with oxygen,correct acidosis and other treatment,respectively,and postoperative blood gas analysis of patients with normal blood gas for 2 hours and 7 hours.Postoperative intestinal obstruction in 1 patients after gastrointestinal decompression,fasting water tube treatment in the postoperative recovery of intestinal function for 91 hours.There were no positive results in the incisal margin of the patients in Da Vinci group,but 3 patients had positive margin after surgery.Da Vinci group 14 patients with clear cell carcinoma after surgery,and the other 1 were renal vascular leiomyoma.17 groups of patients with clear cell carcinoma of human normal postoperative 2 that papillary adenocarcinoma,1 cases abandon color cell carcinoma.The operation time,intraoperative blood loss,postoperative drainage volume,postoperative exhaust time were statistically analyzed,which was statistically significant that P<0.05.follow-up in March patients were no recurrence.conclusionDa Vinci surgical system assisted laparoscopic partial nephrectomy is safe and effective,is an ideal minimally invasive surgery,could reduce the suturing time and blood loss and has the merits of small wound and early recovry than conveentional LPN. |
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