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腹腔镜单孔肾切除术治疗透析相关肾肿瘤的血液透析患者

Laparoendoscopic single-site nephrectomy for hemodialysis patients with dialysis-related renal tumors.

作者信息

Takei Kohei, Yamasaki Mutsushi, Abe Satoki, Yamanaka Naoyuki, Sejiyama Shinya, Narimatsu Takahiro, Hata Shinro, Shibuya Tadamasa, Hirai Kenichi, Ando Tadasuke, Shin Toshitaka, Mori Kenichi, Sumino Yasuhiro, Nomura Takeo, Sato Fuminori, Terachi Toshiro, Mimata Hiromitsu

机构信息

a Department of Urology , Oita University Faculty of Medicine , Oita , Japan.

出版信息

Minim Invasive Ther Allied Technol. 2018 Jun;27(3):153-159. doi: 10.1080/13645706.2017.1335215. Epub 2017 Jun 12.

Abstract

PURPOSE

The purpose of this study is to assess the efficacy of laparoendoscopic single-site (LESS) nephrectomy in hemodialysis patients, we compared outcomes between LESS nephrectomy and conventional laparoendoscopic nephrectomy in hemodialysis patients with dialysis-related renal tumors.

MATERIAL AND METHODS

A total of 16 hemodialysis patients who underwent LESS nephrectomy (LESS-N; n = 8) or conventional laparoendoscopic nephrectomy (C-N; n = 8) between November 2003 and July 2012 were retrospectively evaluated. Outcomes were compared between the two groups.

RESULTS

Patient and tumor characteristics were similar between the LESS-N and C-N groups. The mean operative duration was longer in the LESS-N than in the C-N group (231.0 ± 26.7 min versus 188.6 ± 36.4 min; p = .025). The mean estimated blood loss was lower in the LESS-N compared with the C-N group (26.4 ± 14.4 ml versus 65.6 ± 45.2 ml; p = .047). Postoperative complications were observed in three cases, comprising one case of retroperitoneal hematoma in the LESS-N group and one case each of peritoneal hematoma and retroperitoneal abscess in the C-N group. Surgical scarring was minimal in the LESS-N group.

CONCLUSIONS

Although there is a little extension of the operating time, LESS nephrectomy in hemodialysis patients is a feasible procedure compared with the conventional method.

摘要

目的

本研究旨在评估单孔腹腔镜肾切除术(LESS)在血液透析患者中的疗效,我们比较了LESS肾切除术与传统腹腔镜肾切除术在患有透析相关性肾肿瘤的血液透析患者中的手术结果。

材料与方法

回顾性评估了2003年11月至2012年7月期间接受LESS肾切除术(LESS-N;n = 8)或传统腹腔镜肾切除术(C-N;n = 8)的16例血液透析患者。比较了两组的手术结果。

结果

LESS-N组和C-N组患者及肿瘤特征相似。LESS-N组的平均手术时间比C-N组长(231.0±26.7分钟对188.6±36.4分钟;p = 0.025)。LESS-N组的平均估计失血量低于C-N组(26.4±14.4毫升对65.6±45.2毫升;p = 0.047)。观察到3例术后并发症,包括LESS-N组1例腹膜后血肿,C-N组1例腹膜血肿和1例腹膜后脓肿。LESS-N组手术疤痕最小。

结论

尽管手术时间稍有延长,但与传统方法相比,LESS肾切除术在血液透析患者中是一种可行的手术。

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