Harano Masahiko, Eto Masatoshi, Omoto Kazuya, Tatsugami Katsunori, Nomura Hiroyuki, Koga Hirofumi, Hojyo Morifumi, Yamaguchi Akito, Naito Seiji
Department of Urology, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan.
J Endourol. 2005 Sep;19(7):803-7. doi: 10.1089/end.2005.19.803.
To evaluate the efficacy of hand-assisted laparoscopic radical nephrectomy (HALRN) in patients with localized stage T(1)/T(2) renal-cell carcinoma, we analyzed the clinical results of our patients treated in this way.
From March 1999 to March 2003, a total of 96 patients aged 28 to 86 years (mean 61 years) with clinical stage T(1)/T(2)N(0)M(0), pathologically confirmed renal-cell carcinoma underwent HALRN. The outcomes were compared with those of open radical nephrectomy, which was performed in 86 patients from November 1991 to February 1999 in our institution. Kaplan-Meier analysis was used to analyze survival.
Ten patients (10.4%) had perioperative complications. During a mean follow-up of 25 months (range 6-54 months), no patients died of the cancer, although three patients had metastatic disease. The 4-year disease- free and overall survival rates were 88% and 100%, respectively. Seventy-eight patients who underwent open radical nephrectomy were followed for 38 to 156 months (median 86 months). Seventy-three survived without any recurrent disease, five survived with metastasis, and no patient died of metastatic disease. The 4-year disease-free and overall survival rates were 93% and 100%, respectively.
Hand-assisted laparoscopic surgical management of T(1)/T(2) renal-cell carcinoma is feasible and safe. At our institution, HALRN confers long-term oncologic effectiveness equivalent to that of open radical nephrectomy.
为评估手辅助腹腔镜根治性肾切除术（HALRN）治疗局限性T(1)/T(2)期肾细胞癌患者的疗效，我们分析了采用该方法治疗的患者的临床结果。
1999年3月至2003年3月，共有96例年龄在28至86岁（平均61岁）、临床分期为T(1)/T(2)N(0)M(0)、病理确诊为肾细胞癌的患者接受了HALRN。将结果与1991年11月至1999年2月在本机构接受开放性根治性肾切除术的86例患者的结果进行比较。采用Kaplan-Meier分析来分析生存率。
10例患者（10.4%）出现围手术期并发症。在平均25个月（范围6至54个月）的随访期间，尽管有3例患者出现转移性疾病，但无患者死于癌症。4年无病生存率和总生存率分别为88%和100%。86例接受开放性根治性肾切除术的患者随访了38至156个月（中位时间86个月）。73例患者无疾病复发存活，5例患者有转移存活，无患者死于转移性疾病。4年无病生存率和总生存率分别为93%和100%。
手辅助腹腔镜手术治疗T(1)/T(2)期肾细胞癌是可行且安全的。在本机构，HALRN具有与开放性根治性肾切除术相当的长期肿瘤学疗效。
