복강경 부분신절제술의 초기 경험
Early Experience of Laparoscopic Partial Nephrectomy for Renal Tumor
서일영, 배병준, 임정식,
소속 상세정보
서일영 ( Seo Ill-Young )
원광대학교 의과대학 비뇨기과학교실
배병준 ( Bae Byung-Jun )
원광대학교 의과대학 비뇨기과학교실, 원광의과학연구소
임정식 ( Rim Joung-Sik )
원광대학교 의과대학 비뇨기과학교실
KMID : 0358320070480010001
Abstract
Purpose: To evaluate the feasibility of laparoscopic partial nephrectomy for patients with renal tumors from our early experiences.
Materials & Methods: Between February 2004 and February 2006, 20 patients with renal tumors underwent a laparoscopic partial nephrectomy, and of these, 15 were enrolled in our study. The mean age and body mass index of 6 male and 9 female were 55.2 years and 23.9, respectively. The mean tumor size was 4.2 cm. The operation was performed with a 4 trocar system through a transperitoneal approach. Bleeding from the renal parenchyme was controlled using sutures, argon beam coagulation, fibrin glue and cellulose meshes.
Results: The laparoscopic partial nephrectomies were successfully performed in all patients. The mean operative time and transfusion rate were 180.7 minutes and 60%, respectively. In 6 patients, vascular bulldog clamps were used to remove the tumor mass, with a mean warm ischemic time of 32.5 minutes. The initiation of the postoperative oral intake and ambulation were 1.6 and 2.7 days, respectively, with a mean hospital stay of 8.8 days. Complications were detected in 2 patients, one case each of urinary leakage and an incisional hernia. Pathological examinations revealed renal cell carcinomas with negative surgical margins in 9 patients and angiomyolipomas in a further 6. There was no recurrence during the mean follow-up of 11.4 months.
Conclusion: A laparoscopic partial nephrectomy for a renal tumor can be safely performed. Although excellent perioperative outcomes were observed, long-term follow-up is still necessary to confirm theist effect on cancer control.(Korean J Urol 2007;48:1-5)
키워드
Laparoscopy;Nephrectomy;Kidney neoplasms
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