Chiba Kazuto, Kamada Shuhei, Yamamoto Satoshi, Okato Atsushi, Inoue Toshihito, Nozumi Kazuyoshi, Miyazaki Kanetaka, Inoue Atsushi, Kito Hiroki, Nagata Maki, Kakuta Yukio, Yamaguchi Kunio
Department of Urology, Yokohama-Rosai Hospital.
Department of Pathology, Yokohama-Rosai Hospital.
Nihon Hinyokika Gakkai Zasshi. 2016;107(4):215-219. doi: 10.5980/jpnjurol.107.215.
(Objectives) To evaluate the safety and oncologic efficacy of laparoscopic radical nephrectomy (LRN) for renal cell carcinoma (RCC) >7 cm, we retrospectively reviewed the clinical outcome and long-term cancer control of patients who underwent LRN in comparison to open radical nephrectomy (ORN). (Patients and methods) The clinical records of 79 patients with RCC >7 cm, who underwent radical nephrectomy (37 LRN; 42 ORN) between 1993 and 2014, were reviewed. (Results) The 2 groups (LRN and ORN) were comparable regarding age, body mass index and mean tumor size (86.5 mm vs. 94.6 mm).The operative time was significantly longer in the LRN group than ORN group (204 min vs. 168 min; p<0.05) and blood loss was significantly lower in the LRN group than in the ORN group (144 ml vs. 930 ml; p<0.05).No statistically significant difference was found in complication rate (10.8% vs. 23.8%) and the 2-year recurrence-free survival rate (85.6% vs. 83.8%). (Conclusion) Despite the longer operative time, LRN for large RCC was associated with lower blood loss. This study provides evidence of the safety and efficacy of LRN for large RCC.
(目的)为评估腹腔镜根治性肾切除术(LRN)治疗直径>7 cm肾细胞癌(RCC)的安全性和肿瘤学疗效,我们回顾性分析了接受LRN患者的临床结局和长期癌症控制情况,并与开放性根治性肾切除术(ORN)进行比较。(患者与方法)回顾了1993年至2014年间79例直径>7 cm的RCC患者的临床记录,这些患者均接受了根治性肾切除术(37例行LRN;42例行ORN)。(结果)两组(LRN组和ORN组)在年龄、体重指数和平均肿瘤大小方面具有可比性(86.5 mm对94.6 mm)。LRN组的手术时间明显长于ORN组(204分钟对168分钟;p<0.05),而LRN组的失血量明显低于ORN组(144 ml对930 ml;p<0.05)。两组在并发症发生率(10.8%对23.8%)和2年无复发生存率(85.6%对83.8%)方面未发现统计学上的显著差异。(结论)尽管手术时间较长,但LRN治疗大型RCC的失血量较少。本研究为LRN治疗大型RCC的安全性和有效性提供了证据。