신세포암의 종양 크기에 따른 복강경 근치적 신적출술 결과
Surgical Results of Laparoscopic Radical Nephrectomy According to Tumor Size in Renal Cell Carcinomas
이재환, 서일영, 임정식,
소속 상세정보
이재환 ( Lee Jea-Whan )
원광대학교 의과대학 비뇨기과학교실
서일영 ( Seo Ill-Young )
원광대학교 의과대학 비뇨기과학교실
임정식 ( Rim Joung-Sik )
원광대학교 의과대학 비뇨기과학교실
KMID : 0358320080490030203
Abstract
Purpose: Laparoscopic surgery has been generalized for the treatment of localized renal cell carcinoma(RCC). Recently, laparoscopic radical nephrectomy for an RCC over the pT2 stage has gained rapid momentum as an effective surgery for treatment. We evaluated the possibility of the use of laparoscopic surgery for a large RCC, using the surgical results according to tumor size.
Materials and Methods: Between June 2003 and June 2007, a total of 46 patients that under underwent a laparoscopic radical nephrectomy for RCC were divided into three groups according to tumor size: group 1 (n=16, tumor size ≤4cm), group 2(n=15, tumor size 4cm7cm). The surgical outcomes and perioperative morbidities were evaluated retrospectively, and were compared for each group.
Results: The transfusion rate for group 3 patients was higher than for the other groups(group 1: 0%, group 2: 13.3%, group 3: 26,7%). However, the mean operative time(group 1: 154.3 minutes, group 2: 158.4 minutes, group 3: 197.9 minutes), postoperative initiative time to ambulate(group 1: 1.88 days, group 2: 2.00 days, group 3: 1.87 days) postoperative initiative time to diet(group 1: 1.38 days, group 2: 1.53 days, group 3: 1.53 days), total hospital stay(group 1: 7.94 days, group 2: 8.47 days, group 3: 8.20 days) and complication rate(group 1: 12.5%, group 2: 13.3%, group 3: 13.3%) were similar for patients in the three groups. Pathological results indicated that all cases showed a renal cell carcinoma with a negative surgical margin.
Conclusions: There were no differences in the operative and postoperative results of the performance of laparoscopic radical nephrectomy according to tumor size, except for the transfusion rate. If the use of the technique and experience accumulate, laparoscopic radical nephrectomy will be feasible for all localized RCC regardless of tumor size. (Korean J Urol 2008;49:203-207)
키워드
Renal cell carcinoma;Laparoscopy;Nephrectomy
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