복강경 근치적 신적출술과 개복하 근치적 신적출술의 비교
Comparison of Laparoscopic Radical Nephrectomy with Open Radical Nephrectomy
김태효, 조원열, 곽재진, 윤진한, 성경탁,
소속 상세정보
김태효 ( Kim Tae-Hyo )
동아대학교 의과대학 비뇨기과학교실
조원열 ( Cho Won-Yeol )
동아대학교 의과대학 비뇨기과학교실
곽재진 ( Kwak Jae-Jin )
동아대학교 의과대학 비뇨기과학교실
윤진한 ( Yoon Jin-Han )
동아대학교 의과대학 비뇨기과학교실
성경탁 ( Sung Gyung-Tak )
동아대학교 의과대학 비뇨기과학교실
KMID : 0358320070480030259
Abstract
Purpose: Laparoscopic surgery has become the standard surgical method within the urological community. This study was undertaken to evaluate the safety and efficacy of a standard laparoscopic radical nephrectomy (LRN) compared to an open radical nephrectomy(ORN) at a single medical center.
Materials & Methods: Between January 2003 and March 2006, laparoscopic radical nephrectomies for renal cell cancer were performed in 30 patients and the results of the laparoscopic radical nephrectomy were compared with those of the open counterpart. Surgical results, such as the operation time, estimated blood loss(EBL), transfusion rate, narcotic analgesic requirement, hospital stay, complications and pathologic results, were retrospectively reviewed and analyzed using the Student’s t-test.
Results: There were no significant differences in the demographic data between the two groups. The pathological reports showed a clear cell type in 59 cases and a chromophobe type in 1 case. For the LRN and ORN groups, the mean operation times were 208(120-320) vs. 206 min.(115-300) (p＞0.05), EBL of 135(100-200) vs. 318ml(100-2,000)(p=0.02), transfusion rates of 6.6 vs. 30%, narcotic analgesic requirements of 160 vs. 255mg diclofenac sodium, hospital stays of 6.7 vs. 10.5 days(p=0.04) and intraoperative complications in 0/30(0%) vs. 2/30 cases(7%), respectively. The pathological surgical margins were all negative. The surgical and pathological parameters of the LRN group showed no significant differences to those of the ORN group, with the exception of the EBL and hospital stay.
Conclusion: Laparoscopic radical nephrectomy resulted in less blood loss, a shorter hospital stay and earlier rapid recovery than an open radical nephrectomy. In our opinion, laparoscopic surgery could be a standard surgical treatment in renal cell cancer. (Korean J Urol 2007;48:259-264)
키워드
Renal cancer;Laparoscopy;Nephrectomy
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