CAJ | 학술논문

目的探讨后腹腔镜肾蒂阻断下保留肾单位治疗肾肿瘤的方法及手术技巧. 方法收治肾脏外生性实体肿瘤6例患者,其中.肾细胞癌2例,肿瘤直径分别为2.5 cm和2.2 cm;肾错构瘤4例,肿瘤直径为2.5～3.5 cm.经后腹腔镜径路在自制的肾蒂阻断装置中阻断肾蒂,做保留肾单位的肾肿瘤手术,术中距肿瘤0.5～1.0cm处行肾脏部分切除术,创面缝合止血.结果 6例手术均成功,手术时间120～210min,中位数150min.术中出血150～200ml,中位数170ml.肾蒂血流阻断时间18～33 min,中位数22 min.2例肾细胞癌术后切缘阴性.术后随访6～12个月,未见肿瘤残留及复发.结论后腹腔镜肾脏部分切除术中应用自制的肾蒂阻断装置,具有良好的止血效果、手术创伤小、视野清晰、操作方便、能最大限度地保留患肾等优点,术后恢复良好.
목적 탐토후복강경신체조단하보류신단위치료신종류적방법급수술기교. 방법수치신장외생성실체종류6례환자,기중.신세포암2례,종류직경분별위2.5 cm화2.2 cm;신착구류4례,종류직경위2.5～3.5 cm.경후복강경경로재자제적신체조단장치중조단신체,주보류신단위적신종류수술,술중거종류0.5～1.0cm처행신장부분절제술,창면봉합지혈.결과 6례수술균성공,수술시간120～210min,중위수150min.술중출혈150～200ml,중위수170ml.신체혈류조단시간18～33 min,중위수22 min.2례신세포암술후절연음성.술후수방6～12개월,미견종류잔류급복발.결론 후복강경신장부분절제술중응용자제적신체조단장치,구유량호적지혈효과、수술창상소、시야청석、조작방편、능최대한도지보류환신등우점,술후회복량호.
Objective To evaluate the methods and efficacy of retroperitoneal laparoscopic nephron-sparing surgery for the treatment of renal tumor. Methods A total of 6 patients with renal tumors underwent retroperitoueal laparoscopie nephron-sparing surgery during warm ischacmia. Among the 6 eases, 2 had malignant tumor with the diameter of 2.5 cm and 2.2 cm,and 4 had renal angiomyolipoma with the diameter from 2.5 cm to 3.5 cm.The renal yes,Is were secured by a self-made equipment. Tumors were excised with a cold Endo-shear. Parenehymal edges were approximated using a absorbable hemostatic gauze. Results All procedures were successfully completed without open conversion. Mean surgical time was 150 minutes (range 120-210 minutes). Mean ischaemia time was 22 minutes (range 18-33 minutes) and the mean blood loss was 170 ml (range 150-200 ml). Surgical margins were negative in all patients.During a follow-up for 6-12 months, no patient had local or port site recurrence. Conclusions Betroperitoneal laparoscopic nephron-sparing surgery for renal tumor by using serf-made equipment is safe and effective. This procedure has the advantages of minimal invasion, less blood loss, good vision, and rapid convalescence and so on.