손을 이용한 접근법과 경복막 접근법으로 시행한 복강경하 단순 신절제술의 비교
Comparison of Hand-assisted versus Transperitoneal Laparoscopic Simple Nephrectomy
강일상, 서일영, 정희종,
소속 상세정보
강일상 ( Kang Il-Sang )
원광대학교 의과대학 비뇨기과학교실
서일영 ( Seo Ill-Young )
원광대학교 의과대학 비뇨기과학교실
정희종 ( Jeong Hee-Jong )
원광대학교 의과대학 비뇨기과학교실
KMID : 0358320060470010064
Abstract
Purpose: We compared the results of our experience with hand-assisted laparoscopic simple nephrectomy(HALN) and the standard laparoscopic simple nephrectomy with the transperitoneal approach for treating benign renal diseases.
Materials and Methods: Between March 2002 and March 2004, 38 patients, including 36 patients with a non-functioning kidney and 2 angiomyolipomas, received laparoscopic simple nephrectomies. The HALN approach method was used for 11 patients and transperitoneal standard laparoscopy was used for 27 patients. The operative and clinical records were retrospectively reviewed.
Results: The mean patient age and gender were not significantly different in the HALS and standard groups. The procedures were performed successfully in all but 2 patients. Intraoperatively, one patient of HALN group had spleen injury, which was treated with splenectomy. One patient of the standard group had open conversion due to dissection difficulty because of severe adhesions. Postoperatively, one patient of the standard group had intraperitoneal hematoma, which was treated conservatively. The mean operative time, initiation of the postoperative oral intake and the initiation day for ambulation were not significantly different in both groups. The analgesic use(diclofenac sodium, 90.0mg versus 22.5mg, respectively) and the postoperative hospital stay(7.2 days versus 5.6 days, respectively) was shorter in the standard group than in the HALN group (p＜0.05).
Conclusions: Standard laparoscopic simple nephrectomy with the transperitoneal approach is a less invasive technique than hand-assisted nephrectomy. There is no difference in the technical difficulty according to the operative time and complication rate. (Korean J Urol 2006;47:64-69)
키워드
Laparoscopy;Hand;Nephrectomy
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