Chung Shiu-Dong, Chueh Shih-Chieh, Huang Chao-Yuan, Lai Ming-Kuen, Pu Yeong-Shiau, Yu Hong-Jeng, Huang Kuo-How
Division of Urology, Department of Surgery, Far-Eastern Memorial Hospital, Taipei County, Taipei, Taiwan.
Surg Laparosc Endosc Percutan Tech. 2008 Feb;18(1):49-53. doi: 10.1097/SLE.0b013e318159e84b.
To compare the perioperative parameters, convalescence parameters, and oncologic outcomes of intermediate follow-up between hand-assisted laparoscopic nephroureterectomy (HALNU) and hand-assisted retroperitoneoscopic radical nephroureterectomy (HARNU) in treating upper urinary tract urothelial carcinoma.
We analyzed the data from 48 patients who underwent HALNU and 25 patients who underwent hand-assisted retroperitoneoscopic nephroureterectomy in our institution between January 1999 and December 2003 for UC of the ureter, renal pelvis, or both. Clinical preoperative and perioperative data were collected retrospectively by reviewing medical records. All specimens were pathologically confirmed. The outcomes including bladder recurrence-free survival, metastasis-free survival, cancer-specific survival, and overall survival were compared between the 2 operative methods.
The median follow-up period in the HALNU group was 47.5 months (range, 6 to 72 mo) and 32 months in the HARNU group (range, 21 to 43 mo). Patients' demographic data showed no significant difference between the 2 groups. The operation time was similar between the HALNU group and the HARNU group (223 min vs. 252 min; P=0.11). There was statistically less blood loss in the HALNU group compared with the HARNU group (164 mL vs. 212 mL; P=0.42). The complication rates between the HALNU group and the HARNU group were similar (10.4% and 12%, respectively, P=0.84). There was no open conversion or intraoperative mortality in both groups. The 3-year bladder recurrence-free survival, cancer-specific survival, metastasis-free survival, and overall survival rate were comparable in both groups.
HALNU and HARNU have comparable perioperative parameters, convalescence results, and oncologic outcomes for the management of upper urinary tract urothelial carcinoma from an intermediate follow-up period.
比较手辅助腹腔镜肾输尿管切除术（HALNU）与手辅助后腹腔镜根治性肾输尿管切除术（HARNU）治疗上尿路尿路上皮癌的围手术期参数、康复参数及中期随访的肿瘤学结局。
我们分析了1999年1月至2003年12月间在本机构接受HALNU的48例患者和接受手辅助后腹腔镜肾输尿管切除术的25例患者的数据，这些患者均患有输尿管、肾盂或两者的尿路上皮癌。通过查阅病历回顾性收集临床术前和围手术期数据。所有标本均经病理证实。比较两种手术方法的结局，包括无膀胱复发生存率、无转移生存率、癌症特异性生存率和总生存率。
HALNU组的中位随访期为47.5个月（范围6至72个月），HARNU组为32个月（范围21至43个月）。两组患者的人口统计学数据无显著差异。HALNU组与HARNU组的手术时间相似（223分钟对252分钟；P = 0.11）。与HARNU组相比，HALNU组的术中出血量在统计学上更少（164毫升对212毫升；P = 0.42）。HALNU组与HARNU组的并发症发生率相似（分别为10.4%和12%，P = 0.84）。两组均无开放手术转换或术中死亡。两组的3年无膀胱复发生存率、癌症特异性生存率、无转移生存率和总生存率相当。
从中期随访来看, HALNU和HARNU在治疗上尿路尿路上皮癌方面具有相当的围手术期参数、康复结果和肿瘤学结局。
