The comparison of robot-assisted laparoscopic and open pyelolithotomy in the management of nonstaghorn renal calculi larger than 2 cm
10.3969/j.issn.1672-8467.2019.01.013
- VernacularTitle:机器人辅助腹腔镜与开放肾盂切开取石治疗直径大于2cm非鹿角形肾结石的对比研究
- Author:
Rui-Yi WU
1
;
Li-An SUN
;
Zhi-Bing XU
;
Li LIU
;
Qi-Lai LONG
;
Jian-Ming GUO
;
Guo-Min WANG
Author Information
1. 复旦大学附属中山医院泌尿外科 上海200032
- Keywords:
robot;
laparoscopy;
pyelolithotomy;
renal calculi;
open surgery
- From:
Fudan University Journal of Medical Sciences
2019;46(1):79-83
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the feasibility and safety of robot-assisted laparoscopic pyelolithotomy (RALPL) as the surgical management for nonstaghorn renal calculi larger than 2 cm. Methods Among the patients admitted to our hospital for nonstaghorn renal calculi larger than 2 cm between Jun. ,2013 and Jun. ,2017, a retrospective analysis was performed on the treatment outcome of patients undergoing RALPL (48 cases) and open pyelolithotomy (OPL) (44 cases). The initial stone-free rate, mean operating time, hemoglobin drop, off-bed activity time and hospital stay were compared between two groups. Results Compared with OPL group, RALPL group had a higher initial stone-free rate (91. 66% vs. 70.45%, P < 0.05), and had significant lesser hemoglobin drop, shorter operating time, off-bed activity time and hospital stay. There was no ClavienⅡ or above complications in RALPL group, but there were 2 cases of ClavienⅡcomplications in OPL group. Conclusions Transperitoneal approach RALPL has a better visual angle to observe renal pelvis and calyces, and can ensure a higher initial stone-free rate under the conditions of low intrarenal pelvic pressure and leaving renal parenchyma and vessels intact. RALPL is a minimally invasive, effective and safe treatment, and is an alternative indication for renal calculi larger than 2 cm (including renal pelvis stones with accompanying renal calyceal stones).
