机器人辅助腹腔镜和4K超清腹腔镜肾部分切除术治疗局限性肾细胞癌的疗效比较

doi:10.3969/j.issn.1005-6483.20241855

临床外科杂志 ›› 2026, Vol. 34 ›› Issue (2): 214-217.doi: 10.3969/j.issn.1005-6483.20241855

机器人辅助腹腔镜和4K超清腹腔镜肾部分切除术治疗局限性肾细胞癌的疗效比较

430081 湖北武汉，武汉科技大学附属华润武钢总医院（郭治水、伍庄）；武汉科技大学医学部医学院（郭治水）；黄冈市中心医院（徐涛、刘辉勇、杜恒

收稿日期:2024-11-20 接受日期:2024-11-20 出版日期:2026-02-25 发布日期:2026-02-25
通讯作者: 伍庄，Email:378111992@qq.com
基金资助:
湖北省自然科学基金青年项目（2022CFB799）

The efficacy comparison between robot-assisted laparoscopic and 4K ultra-high-definition laparoscopic partial nephrectomy in the treatment of localized renal cell carcinoma

Department of Urology，Wuhan University of Science and Technology Affiliated CR & WISCO General Hospital，Wuhan 430081，China

Received:2024-11-20 Accepted:2024-11-20 Online:2026-02-25 Published:2026-02-25

摘要/Abstract

摘要： 目的探讨机器人辅助腹腔镜肾部分切除术（pobot assisted partial nephrectomy,RAPN）与4K超清腹腔镜肾部分切除术（4K-ultra high definition laparoscopic partial Nephrectomy,4K-LPN）治疗局限性肾细胞癌的效果和安全性。方法 2022年4月~2024年8月黄冈市中心医院行肾部分切除术局限性肾细胞癌病人63例，根据手术方式不同分为RAPN组（31例）和4K-LPN组（32例）。比较两组病人术前一般资料、围术期资料、肿瘤特征、住院时间、住院总费用及术后短期并发症发生情况。结果 RAPN组和4K-LPN组术中出血量分别为(151.2±13.5)ml和(184.6±14.0)ml，肾脏热缺血时间分别为(21.9±3.8）分钟和(24.3±3.5)分钟，手术时间分别为（179.6±21.4）分钟和（196.4±31.6）分钟，术后1天肌酐上升值分别为(12.8±14.2)μmol/L和(21.4±14.6)μmol/L，两组比较差异有统计学意义( P＜0.05)；RAPN组的住院总费用为（38798.1±10609.3）元，明显高于4K-LPN组的（27925.9±5793.9）元，两组比较差异有统计学意义（P＜0.05)；两组切缘阳性率比较，差异无统计学意义（P＞0.05）；两组病人术中输血率、拔除引流管时间、拔除导尿管时间、术后住院时间及术后2周并发症发生率比较,差异无统计学意义（P＞0.05）。结论与4K-LPN相比，RAPN具有术中出血量少、肾脏热缺血时间短、手术时间短、更好地保护肾功能等明显优势，但机器人手术价格昂贵，限制其广泛应用。

关键词: 机器人辅助腹腔镜, 4K超清腹腔镜, 肾部分切除术, 局限性肾细胞癌

Abstract: Objective To evaluate the effect of robotassisted partial nephrectomy (RAPN) and 4K ultra-high-definition laparoscopic partial nephrectomy (4K-LPN) in the treatment of localized renal cell carcinoma.Mtheods A retrospective analysis was conducted on 63 patients with localized renal cell carcinoma who underwent partial nephrectomy at Huanggang Central Hospital from April 2022 to August 2024.Based on the surgical approach,patients were divided into the RAPN group (n=31) and the 4K-LPN group (n=32).The preoperative baseline characteristics,perioperative data,tumor features,hospital stay,total hospitalization costs,and short-term postoperative complications were compared between the two groups.Results The intraoperative blood loss in the RAPN group and the 4K-LPN group was (151.2±13.5)ml and (184.6±14.0)ml respectively,and the warm ischemia time of the kidneys was (21.9±3.8) minutes and (24.3±3.5) minutes respectively.The operation times were (179.6±21.4) minutes and (196.4±31.6) minutes respectively.The increase in creatinine one day after the operation was (12.8±14.2 )μmol/L and (21.4±14.6)μmol/L respectively.There was a statistically significant difference between the two groups (P< 0.05).However,the total hospitalization cost was significantly higher in the RAPN group (38 798.1±10 609.3 CNY vs.27 925.9±5 793.9 CNY,P<0.05).No significant differences were observed in positive surgical margin rates (P>0.05).Additionally,there were no statistically significant differences between the two groups regarding intraoperative transfusion rates,drainage tube removal time,catheter removal time,postoperative hospital stay,or 2-week postoperative complication rates (P>0.05).Conclusion Compared with 4K-LPN,RAPN offers significant advantages,including reduced intraoperative blood loss,shorter renal warm ischemia time,shorter operative duration,and better renal function preservation.However,the high cost of robotic surgery remains a major limiting factor for its widespread adoption.

Key words: robot-assisted laparoscopy, 4K ultra-high definition laparoscopy, partial nephrectomy, localized renal cell carcinoma

郭治水伍庄徐涛刘辉勇杜恒. 机器人辅助腹腔镜和4K超清腹腔镜肾部分切除术治疗局限性肾细胞癌的疗效比较[J]. 临床外科杂志, 2026, 34(2): 214-217.

GUO Zhishui, WU Zhuang, XU Tao, LIU Huiyong, DU Heng. The efficacy comparison between robot-assisted laparoscopic and 4K ultra-high-definition laparoscopic partial nephrectomy in the treatment of localized renal cell carcinoma[J]. JOURNAL OF CLINICAL SURGERY, 2026, 34(2): 214-217.

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机器人辅助腹腔镜和4K超清腹腔镜肾部分切除术治疗局限性肾细胞癌的疗效比较

The efficacy comparison between robot-assisted laparoscopic and 4K ultra-high-definition laparoscopic partial nephrectomy in the treatment of localized renal cell carcinoma

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