상부요로계의 요로상피세포암 환자에서 시행한 복강경 신요관적출술: 안전성과 효용성
Laparoscopic Nephroureterectomy in Patient with an Upper Urinary Tract Transitional Cell Carcinoma: Safety and Efficacy
공근수, 배상락, 조성호, 서주형, 성경탁,
소속 상세정보
공근수 ( Kong Geun-Soo )
동아대학교 의과대학 비뇨기과학교실
배상락 ( Bae Sang-Rak )
동아대학교 의과대학 비뇨기과학교실
조성호 ( Cho Seong-Ho )
동아대학교 의과대학 비뇨기과학교실
서주형 ( Seo Ju-Hyung )
동아대학교 의과대학 비뇨기과학교실
성경탁 ( Sung Gyung-Tak )
동아대학교 의과대학 비뇨기과학교실
KMID : 0358320070480030252
Abstract
Purpose: To evaluate the safety and efficacy of a laparoscopic nephroureterectomy in patients with a transitional cell carcinoma of the renal pelvis and ureter.
Materials & Methods: All patients underwent a nephroureterectomy for an upper tract transitional cell carcinoma. Of these, 23 and 22 underwent a laparoscopic nephroureterectomy(LNU) and open nephroureterectomy (ONU), respectively, between January 2002 and June 2006. After the nephrectomy had been performed, a 5-6cm modified Gibson incision was created to allow dissection of the lower ureter and bladder cuff, and extraction of the intact specimen. A retrospective analysis was performed on the operating time, blood loss, analgesic requirement, ambulation time, interval to resume oral intake, hospital stay, complications and follow-up results for both groups.
Results: The LNU was superior to the ONU with regard to the mean operation time; 275(190-390) versus 258(180-400)(p=0.259), blood loss; 188 (130-250) versus 488ml(350-750)(p＜0.05), ambulation time; 2.5 versus 3.3 days(p＜0.05), interval to resume oral intake 2.1 versus 2.8 days(p＜0.05), and hospital stay; 8.3 versus 11.1 days(p＜0.05). Complications developed in 4 and 5 of the LNU and ONU patients, respectively, but all were resolved with conservative management. The mean follow-up duration of the LNU and ONU groups were 29 versus 14 months, respectively.
Conclusion: Based on our experience, a laparoscopic nephroureterectomy is better tolerated with respect to pain, has less blood loss, shorter hospital stays, ambulation time and time to oral intake. LNU is safe for an upper tract transitional cell carcinoma, and is also an efficacious alternative to open surgery. However, a long-term follow-up will be warranted to ascertain accurate oncologic data.(Korean J Urol 2007;48:252-258)
키워드
Nephrectomy;Transitional cell carcinoma;Urinary tract
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