腹腔镜肾输尿管切除术治疗上尿路移行细胞癌：腹腔镜手术与开放手术的比较

Laparoscopic nephroureterectomy for upper tract transitional cell carcinoma: comparison of laparoscopic and open surgery.

作者信息

Tsujihata Masao, Nonomura Norio, Tsujimura Akira, Yoshimura Kazuhiro, Miyagawa Yasushi, Okuyama Akihiko

机构信息

Department of Urology, Osaka University Graduate School of Medicine, Suita Japan.

出版信息

Eur Urol. 2006 Feb;49(2):332-6. doi: 10.1016/j.eururo.2005.11.013. Epub 2005 Dec 20.

DOI:10.1016/j.eururo.2005.11.013

PMID:16387415

Abstract

OBJECTIVES

We made a comparative study of laparoscopic nephroureterectomy (LNU) and standard open surgery (ONU) for upper urinary tract transitional cell carcinoma.

METHODS AND METHODS

From July 2000 to February 2005, 49 patients underwent total nephroureterectomy for upper tract transitional cell carcinoma at Osaka University Medical Hospital. Of the 49 patients, twenty-five were treated with LNU, and twenty-four with ONU. Each group of cases was reviewed with respect to operative time, complications and postoperative convalescence.

RESULTS

The average operative time of the LNU and ONU group was 305.9 min (range 190-480) and 271.2 min (range 135-480) respectively, and the average blood loss was 321.5 ml (80-1370) and 557.7 ml (range 100-1730), respectively. The average time until ambulation after LNU and ONU was 2.2 days (range 1-3) and 4.0 days (range 3-5), respectively. No major postoperative complications were observed in either group.

CONCLUSION

ONU still represents the gold standard for the management of upper tract transitional cell carcinoma; however, for low stage cases, LNU offers the advantages of minimally invasive surgery.

摘要

目的

我们对上尿路移行细胞癌的腹腔镜肾输尿管切除术（LNU）和标准开放手术（ONU）进行了一项对比研究。

方法

2000年7月至2005年2月，大阪大学医学部附属医院有49例患者因上尿路移行细胞癌接受了全肾输尿管切除术。在这49例患者中，25例行LNU治疗，24例行ONU治疗。对每组病例的手术时间、并发症及术后恢复情况进行了回顾分析。

结果

LNU组和ONU组的平均手术时间分别为305.9分钟（范围190 - 480分钟）和271.2分钟（范围135 - 480分钟），平均失血量分别为321.5毫升（80 - 1370毫升）和557.7毫升（范围100 - 1730毫升）。LNU组和ONU组术后平均下床活动时间分别为2.2天（范围1 - 3天）和4.0天（范围3 - 5天）。两组均未观察到严重的术后并发症。