Ono Y, Katoh N, Kinukawa T, Matsuura O, Ohshima S
Department of Urology, Komaki Shimin Hospital, Okazaki City Hospital, Komaki-shi, Japan.
J Urol. 1997 Sep;158(3 Pt 1):719-23.
We evaluated the efficacy of laparoscopic radical nephrectomy for removing kidneys with small volume renal cell carcinoma.
25 patients (19 men and 6 women, mean age 59) who had a kidney with small volume renal cell carcinoma (diameter less than 5 cm.), underwent laparoscopic radical nephrectomy. The kidney was dissected laparoscopically together with the adrenal gland, perirenal fatty tissue and Gerota's fascia. In 11 patients, we used the transperitoneal approach and in the remaining 14 we used the retroperitoneal approach, in which a working space is created by finger and balloon dissection. We maneuvered the kidney into the laparoscopy sack, which was then removed through an additional 5 to 6 cm. incision.
All 25 kidneys were removed successfully. Mean operation time was 5.3 hours and mean estimated blood loss was 335 ml. There were 5 complications, including a patient who suffered an injury to the duodenum, which was treated by open duodenojejunostomy. Full convalescence occurred at an average 23 days. No metastatic disease, no local recurrence and no seeding at the port sites occurred during the followup of 7 to 49 months (mean, 22 months).
Laparoscopic radical nephrectomy is recommended as a minimally invasive procedure for removing kidneys with small volume renal cell carcinoma.
我们评估了腹腔镜根治性肾切除术治疗小体积肾细胞癌肾脏的疗效。
25例（19例男性和6例女性，平均年龄59岁）患有小体积肾细胞癌（直径小于5厘米）的患者接受了腹腔镜根治性肾切除术。通过腹腔镜将肾脏连同肾上腺、肾周脂肪组织和肾筋膜一并切除。11例患者采用经腹腔途径，其余14例采用后腹腔途径，后者通过手指和球囊分离创建工作空间。我们将肾脏移入腹腔镜袋，然后通过额外的5至6厘米切口将其取出。
所有25个肾脏均成功切除。平均手术时间为5.3小时，平均估计失血量为335毫升。发生了5例并发症，其中1例患者十二指肠受损，通过开放十二指肠空肠吻合术进行治疗。平均23天完全康复。在7至49个月（平均22个月）的随访期间，未发生转移性疾病、局部复发和切口种植。
腹腔镜根治性肾切除术推荐作为治疗小体积肾细胞癌肾脏的微创手术。
