상부요로 이행세포암에 대한 경복막강경 신요관적출술: 관혈적 수술과의 비교
Transperitoneal Laparoscopic Nephroureterectomy for Upper Urinary Tract Transitional Cell Carcinoma: A Comparison with Open Nephroureterectomy
이준녕, 권태균, 김현태,
소속 상세정보
이준녕 ( Lee Jun-Nyung )
경북대학교 의과대학 비뇨기과학교실
권태균 ( Kwon Tae-Gyun )
경북대학교 의과대학 비뇨기과학교실
김현태 ( Kim Hyun-Tae )
경북대학교 의과대학 비뇨기과학교실
KMID : 0358320070480040371
Abstract
Purpose: Laparoscopic nephroureterectomy(LNUx) has recently been done to treat patients with upper tract transitional cell carcinoma. We retrospectively evaluated the efficacy and safety of LNUx in comparison with open nephroureterectomy(ONUx).
Materials & Methods: Between May 2001 and March 2006, a total of 51 patients underwent radical nephroureterectomy for upper tract transitional cell carcinoma, including 22 LNUx and 29 ONUx. LNUx was performed transperitoneally and the ureteral end with a bladder cuff was transected through a 5-7cm modified Gibson incision. All the specimens were extracted intact. The patients’ characteristics and the perioperative and followup data were analyzed retrospectively.
Results: LNUx was successfully performed in all the patients without open conversion. The analgesic requirement was lower, and the average time to oral intake and the length of hospitalization were shorter for LNUx than for ONUx. The average operative time, estimated blood loss and complications were not statistically different between the LNUx and ONUx. The mean follow-up periods of the LNUx and ONUx were 13.7 and 30.0 months, respectively. Both groups were similar in regard to bladder recurrence, local recurrence and distant metastasis. There was no sign of the trocar site or peritoneal seeding after LNUx.
Conclusion: Our results suggest that LNUx is an acceptable alternative to ONUx for treating upper urinary tract transitional cell carcinoma. However, a longer follow-up period and comparative studies to the standard open techniques will be required. (Korean J Urol 2007;48:371-375)
키워드
Carcinoma; transitional cell; Laparoscopic surgery; Nephrectomy
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