Department of Urology, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan.
J Formos Med Assoc. 2012 Jan;111(1):41-5. doi: 10.1016/j.jfma.2012.01.002. Epub 2012 Feb 2.
BACKGROUND/PURPOSE: To evaluate the long-term oncological outcomes of hand-assisted retroperitoneoscopic radical nephrectomy (HARRN) for treating clinically localized renal cell carcinoma.
We retrospectively collected and analyzed the data and clinical outcomes of 46 patients who underwent HARRN and 50 patients who underwent conventional open radical nephrectomy (ORN) at our institution for clinical localized renal cell carcinoma (RCC).
The median follow-up period of the HARRN group was 56.5 months (range: 14.6-78.7 months); for the ORN group, the median follow-up period was 110.8 months (range: 15.5-123 months). Patient age, sex, body mass index, pathologic parameters, and classification based on the guidelines of the American Society of Anesthesiologists were not significantly different between the two groups. The HARRN group had a significantly longer operative time (218 minutes vs. 178 minutes, p = 0.003) and less blood loss (203 mL vs. 670 mL, p < 0.001). The complication rates of the ORN and HARRN groups were similar (8% and 4.3%, respectively, p = 0.46). No conversions to an open procedure or intraoperative mortality occurred in the HARRN group. The disease-free and disease-specific survival rates were comparable between the two groups.
The results of our study indicate that HARRN is a feasible, minimally invasive treatment for managing clinically organ-confined RCC with a good long-term oncological outcome.
背景/目的：评估手助式后腹腔镜根治性肾切除术（HARRN）治疗局限性肾细胞癌的长期肿瘤学结果。
我们回顾性地收集并分析了在我院接受 HARRN 治疗的 46 例局限性肾细胞癌（RCC）患者和接受传统开放性根治性肾切除术（ORN）治疗的 50 例患者的数据和临床结果。
HARRN 组的中位随访时间为 56.5 个月（范围：14.6-78.7 个月）；ORN 组的中位随访时间为 110.8 个月（范围：15.5-123 个月）。两组患者的年龄、性别、体重指数、病理参数和美国麻醉医师协会指南分类无显著差异。HARRN 组的手术时间明显更长（218 分钟比 178 分钟，p=0.003），出血量更少（203 毫升比 670 毫升，p<0.001）。ORN 组和 HARRN 组的并发症发生率相似（8%和 4.3%，p=0.46）。HARRN 组无中转开放手术或术中死亡。两组患者的无病生存率和疾病特异性生存率相当。
我们的研究结果表明，HARRN 是一种可行的微创治疗方法，适用于治疗临床局限性 RCC，具有良好的长期肿瘤学结果。
