演題抄録

一般演題 (示説)

開催概要
開催回
第53回・2015年・京都
 

Imperative腎部分切除術の検討

演題番号 : P95-11

[筆頭演者]
川田 望:1 
[共同演者]
吉澤 剛:1、五十嵐 智博:1、松井 強:2、平方 仁:1、山口 健哉:2、高橋 悟:2

1:駿河台日本大学泌尿器科、2:日本大学医学部泌尿器科

 

Objective
However, increasing trend towards elective nephron sparing surgery (ENS), only a few studies can be found imperative nephron sparing surgery (INS). In this study we compared patients after they had undergone NSS with regard to renal function and oncological long-term follow up.
Method
We defined two groups, A group consisted of RCC occurred after radical nephrectomy in 5 cases and RCC occurred in patient with congenital single kidney in one case, on the other hand B group consisted of two patients who had bilateral renal tumors simultaneously.
Result
The mean follow-up was 89months (range 24-228 months), all of 7 patients survived without recurrence.
A group; previous pathological revealed that 5 cases were clear cell carcinoma (CCC), pathological grade 1-2, pT1a-2, average recurrence duration were 113months, Preoperative evaluation, nephrometry score were 4-10 point (average 6 point) all cases were CCC. 4 cases were pT1a, remaining case was pT3a, Clampless had underwent 3cases, 2 cases had used microtase coagulator, remaining one case underwent soft coagulator with suture less procedure. The mean preoperative GFR was 56ml/min, and mean postoperative GFR was 53ml/min. Two of them showed postoperative recurrence, mean time was 96 months. The mean preoperative GFR was 55ml/min, and mean postoperative GFR was 46min/ml.
B group; All of two patients underwent partial nephrectomy for one side tumor which had a larger size than another one. Several months later patients underwent surgical procedure with contra lateral tumor. All tumor resection underwent with mechanical renal pedicle clamping.
The mean preoperative GFR was 50.5ml/min. and postoperative GFR was 33.4ml/min. then one of them had underwent hemodialysis 4 years later.
Conclusion
However oncologic surgical outcome seems to be appropriate for INS, regarding postoperative renal function, indication of INS for bilateral tumors should be consideration.

キーワード

臓器別:腎・尿路・膀胱

手法別:手術療法

前へ戻る