Ono Yoshinari, Hattori Ryohei, Gotoh Momokazu, Yoshino Yasushi, Yoshikawa Yoko, Kamihira Osamu
Department of Urology, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya 466-0064, Japan.
Curr Opin Urol. 2005 Mar;15(2):75-8. doi: 10.1097/01.mou.0000160619.28613.3c.
Laparoscopic radical nephrectomy has been developed and applied for patients with renal cell carcinoma since 1992. The number of patients undergoing laparoscopic radical nephrectomy has increased explosively worldwide in recent years, and laparoscopy is now extended to patients with advanced disease. It is very important to clarify the present status of laparoscopic radical nephrectomy among the treatment modalities for patients with renal cell carcinoma.
Laparoscopic radical nephrectomy has a minimally invasive nature as well as comparable long-term cancer control in patients with pT1-3a renal cell carcinoma to open surgery. It is technically applicable for N1-2 disease and T3b disease if the tumor thrombus is within the renal vein. Also, it is feasible as a cytoreductive surgery for patients with M1 disease.
Laparoscopic radical nephrectomy is a standard treatment modality for T1-3a renal cell carcinoma patients. It is also available for treating patients with N1-2 disease, and for patients with M1 disease as a cytoreductive surgery.
自1992年以来，腹腔镜根治性肾切除术已被开发并应用于肾细胞癌患者。近年来，全球接受腹腔镜根治性肾切除术的患者数量呈爆发式增长，现在腹腔镜手术已扩展至晚期疾病患者。明确腹腔镜根治性肾切除术在肾细胞癌患者治疗方式中的现状非常重要。
对于pT1-3a期肾细胞癌患者，腹腔镜根治性肾切除术具有微创性，且在长期癌症控制方面与开放手术相当。如果肿瘤血栓位于肾静脉内，在技术上适用于N1-2期疾病和T3b期疾病。此外，对于M1期疾病患者，作为减瘤手术也是可行的。
腹腔镜根治性肾切除术是T1-3a期肾细胞癌患者的标准治疗方式。它也可用于治疗N1-2期疾病患者，以及作为减瘤手术用于治疗M1期疾病患者。
