pT1 신세포암에서 시행한 순수 복강경 및 손을 이용한 복강경 근치적 신적출술의 종양학적 및 수술적 결과: 개복 근치적 신적출술과의 비교
Oncological and Surgical Outcomes of Pure Laparoscopic Radical Nephrectomy and Hand-Assisted Laparoscopic Radical Nephrectomy for pT1 Renal Cell Carcinoma: Comparison with Open Radical Nephrectomy
김명, 박용현, 이상은, 곽철, 김현회,
소속 상세정보
김명 ( Kim Myong )
서울대학교 의과대학 비뇨기과학교실
박용현 ( Park Yong-Hyun )
서울대학교 의과대학 비뇨기과학교실
이상은 ( Lee Sang-Eun )
서울대학교 의과대학 비뇨기과학교실
곽철 ( Kwak Cheol )
서울대학교 의과대학 비뇨기과학교실
김현회 ( Kim Hyeon-Hoe )
서울대학교 의과대학 비뇨기과학교실
KMID : 0358320090500050457
Abstract
Purpose: We compared the surgical and oncologic outcomes of pure laparoscopic radical nephrectomy (PLRN) and hand-assisted laparoscopic radical nephrectomy (HLRN) with those of open radical nephrectomy (ORN) in patients with pT1 renal cell carcinoma (RCC).
Materials and Methods: Between 1999 and 2007, a total of 269 patients underwent PLRN (n=77), HLRN (n=87), and ORN (n=105) for pT1 RCC. Follow-up data consisted of clinical, pathologic, and oncologic results and were reviewed retrospectively. Kaplan-Meier survival curves were constructed for progression and survival endpoints.
Results: Mean operative time was 184.0, 164.0, and 132.6 minutes (p＜ 0.001); mean estimated blood loss was 196.7, 147.8, and 232.6 ml (p＜0.001); and mean postoperative hospital stay was 5.7, 7.2, and 7.8 days (p＜0.001) for the PLRN, HLRN and ORN groups, respectively. The major complication rate after surgery was 2.6%, 2.3%, and 3.8%, respectively (p=0.807). Median follow-up periods were 32 months in the PLRN group, 48 months in the HLRN group, and 37 months in the ORN group. Five-year progression-free survival was 97.4%, 96.6%, and 98.1% (p=0.557), and 5-year cancer-specific survival was 98.7%, 96.6%, and 98.1% (p=0.508), respectively.
Conclusions: PLRN and HLRN are safe treatment options with comparable oncologic results to ORN for pT1 RCC.
키워드
Renal cell carcinoma;Nephrectomy;Laparoscopic surgery;Treatment outcome
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