机器人外科学杂志（中英文）2025，Vol.6Issue(9)：1465-1470,6.DOI:10.12180/j.issn.2096-7721.2025.09.005
微创根治性肾输尿管切除术手术难度的影响因素分析
Analysis of factors influencing the surgical difficulty of minimally invasive radical nephroureterectomy
摘要
Abstract
Objective:To investigate factors influencing the surgical difficulty of minimally invasive radical nephroureterectomy for upper tract urothelial carcinoma(UTUC).Methods:A retrospective analysis was conducted on UTUC patients who underwent laparoscopic nephroureterectomy(LNU)or robot-assisted laparoscopic nephroureterectomy(RANU)at the First Medical Center and Fifth Medical Center of the Chinese PLA General Hospital from December 2018 to January 2024.Patients were divided into the difficult group(n=29)and the normal group(n=69)based on operative time.Univariate and multivariate analyses were performed to investigate factors influencing surgical difficulty.Results:Univariate analysis indicated that operative time,interspinous diameter,intersciatic diameter,sacrococcygeal distance,ureteral deviation angle from the midline,interspinous/intersciatic diameter ratio,intraoperative blood loss,cosine of the angle,and gender were influencing factors(P<0.05).Multivariate Logistic regression identified female gender,greater blood loss,and longer sacrococcygeal distance as risk factors(OR>1,P<0.05),while larger ureteral deviation angle and higher interspinous/intersciatic diameter ratio were protective factors(OR<1,P<0.05).Conclusion:Preoperative evaluation of these factors may help predict surgical difficulty and optimize operative planning for UTUC patients undergoing LNU/RANU,which can reduce operative time and risks.关键词
上尿路尿路上皮癌/根治性肾输尿管切除术/腹腔镜手术/机器人辅助手术/影响因素Key words
Upper Tract Urothelial Carcinoma/Radical Nephroureterectomy/Laparoscopic Surgery/Robot-assisted Surgery/Influencing Factors分类
医药卫生引用本文复制引用
李学超,杨涛,左世栋,董金凯,付成伟,孔令生,陈立军..微创根治性肾输尿管切除术手术难度的影响因素分析[J].机器人外科学杂志（中英文）,2025,6(9):1465-1470,6.基金项目
国家自然科学基金(82173085)National Natural Science Foundation of China(82173085) （82173085）
