CAJ | 학술논문

目的探讨腰部解剖性入路在T1期肾癌根治术中的应用.方法 39例T1期肾癌患者解剖性分离肾周筋膜后间隙和肾前间隙,先行阻断肾动静脉,在肾周筋膜外将肾脏及肿瘤完整切除,随访观察疗效.结果 39例手术均顺利完成.23例肿瘤直径＜ 4cm,手术时间60 ～ 90 min,平均65 min,术中出血量20 ～ 50ml;16例肿瘤直径4～7cm,手术时间80 ～ 120 min,平均95 min,术中出血量30～100 ml,无胸膜及下腔静脉损伤.术后住院时间7～10d,平均9天,随访时间3～ 36个月,肿瘤无复发转移.结论腰部解剖性入路行T1期肾癌根治术安全,出血少,实用性强,复发率低,是适用于基层医院的一种有效的开放术式.
목적 탐토요부해부성입로재T1기신암근치술중적응용.방법 39례T1기신암환자해부성분리신주근막후간극화신전간극,선행조단신동정맥,재신주근막외장신장급종류완정절제,수방관찰료효.결과 39례수술균순리완성.23례종류직경＜ 4cm,수술시간60 ～ 90 min,평균65 min,술중출혈량20 ～ 50ml;16례종류직경4～7cm,수술시간80 ～ 120 min,평균95 min,술중출혈량30～100 ml,무흉막급하강정맥손상.술후주원시간7～10d,평균9천,수방시간3～ 36개월,종류무복발전이.결론 요부해부성입로행T1기신암근치술안전,출혈소,실용성강,복발솔저,시괄용우기층의원적일충유효적개방술식.
Objective To investigate the clinical application effects of open lumbar anatomical radical nephrectomy in T1 Renal cell carcinoma (RCC).Methods We dissociated anatomically anterior and post diastema of peri-renal fascia and isolated the vessel of kidney,and successively blocked renal arteries and veins,then removed kidney and tumor.The clinical information of 39 patients was analyzed to see the results of the treatment.Results All cases of surgeries were successful.23 cases of tumor diameter were less than 4 cm,and operation time was 60～90 minutes.The mean operation time was 65 minutes,and the bleeding quantity was 20 ～50 ml.Also,there was 16 cases of tumor diameter was between 4cm to 7 cm,and operation time was 80～120 minutes.The mean operation time was 95 minutes,and the bleeding quantity was 30 ～100 ml; however,there were not injuries in pleura and postcava.The time of hospital stay was 7 ～10 days,and the mean time was 9 days.All cases were followed by 3～36 months.There were no patients needing metastasis.Conclusion Open lumbar anatomical radical nephrectomy is associate with higher safety,lower blood loss,higher usefulness,lower recurrence rate.It is a very useful method for basic level hospital to treat T1 RCC.