使用機器人輔助部分腎臟切除術治療大於6公分之腎臟贅生瘤
林宜佳1,2、何肇晏1、吳子翔1、莊光達1,2、葉忠信1,2、鄭以弘1、仇光宇1,2、
陳宏恩1、蔡德甫1,2、黃一勝1,2
1新光醫院外科部泌尿科、2輔仁大學醫學院醫學系
Robotic-assisted partial nephrectomy for renal angiomyolipoma larger than 6 cm
Yi-Chia Lin1,2, Chao-Yen Ho1, Tze-Shang Wu1, Guang-Dar Juang1,2, Chung-Hsin Yeh1,2, Yi-Hong Cheng1, Kuang-Yu Chou1,2, Hung-En Chen1,Te-Fu Tsai 1,2,
and Thomas I-Sheng Hwang1,2
Department of Urology, Shin Kong Wu Ho-Su Memorial Hospital1, School of Medicine, Fu-Jen Catholic University2, Taipei, Taiwan.
Background: Angiomyolipoma(AML) is a rare benign renal neoplasm. AML larger than 4 cm posses the risk of spontaneous rupture and requires management. Robotic partial nephrectomy (RAPN) has been proved to be an effective treatment modality for renal tumors. Herein, we report our experience in RAPN for large AML.
Materials and methods: From June, 2015 to March 2017, a total of 62 RAPN was performed in our hospital. Among the procedures, 8 patients were identified as AML larger than 6 cm. The demographics, perioperative parameters and post-operative details were collected and analyzed retrospectively.
Results: Among the 8 patients, 6 were females and 2 were males. The median age was 54 (21-65) years old. Five tumors were located in the left side and 3 in the right side. The median maximal size of the tumor was 7.5 (6-13) cm. The median R.E.N.A.L nephrometry score was 7.5 (7-10). Median operative time was 200 (120-300) minutes and median blood loss was 200 (50-450) ml. No intra-operative complication was noted. The median warm ischemia time was 14 (0-40) minutes. The median Hospital stay was 6.5 (5-9) days. The median preoperative and post-operative creatinine level was 0.72 (0.46-1.26) and 0.84 (0.56-1.38) mg/dL, respectively. No postoperative complication and recurrence can be found.
Conclusion: RAPN is a safe and effective surgical procedure for large AML. The complication rate is low. For patients with large ANL, RAPN can be a standard approach.