Oncologic outcome of hand-assisted laparoscopic radical nephrectomy
Oncologic outcome of hand-assisted laparoscopic radical nephrectomy
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DOI：
10.1016/j.urology.2006.09.009
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发表时间：
2007-01-01
期刊：
影响因子：
2.1
通讯作者：
Miki, Tsuneharu
中科院分区：
文献类型：
--
作者：
Kawauchi, Akihiro;Yoneda, Kimihiko;Miki, Tsuneharu
目的评价和比较手辅助后腹腔镜肾癌根治术（HALS）与开放肾癌根治术的肿瘤学疗效.方法回顾性分析123例行HALS的局限性肾癌患者与70例行开放肾癌根治术患者的临床及随访资料.结果两种术式在手术时间、并发症发生率、手术并发症发生率等方面均无显著性差异.结论手辅助后腹腔镜肾癌根治术是治疗局限性肾癌的有效方法.或输血率之间的差异。HALS组的估计失血量显著较少。HALS组的中位随访时间为41.0个月，明显短于开放组（74.5个月）。HALS组和开放组的3年和5年无病生存率分别为94%和92%以及93%和91%。HALS组和开放组的3年和5年癌症特异性生存率分别为96%和92%以及98%和94%。两组的无病生存率和癌症特异性生存率无显著差异。在HALS组中，无病生存率之间没有显着差异，发现那些经历手术的经验不足的外科医生进行腹腔镜肾切除术的10例或更少，那些经历手术的经验丰富的surgeon.CONCLUSIONS的肿瘤HALS的结果并没有太大的不同，从开放的方法。此外，外科医生的经验不影响肿瘤学结局。然而，延长随访是必要的，以评估真正的肿瘤疗效HALS。(c)2007爱思唯尔公司
OBJECTIVES To evaluate and compare the oncologic outcome of hand-assisted retroperitoneoscopic radical nephrectomy (HALS) with that of open radical nephrectomy.METHODS The clinical and follow-up data of 123 patients with localized renal cell carcinoma who underwent HALS were retrospectively compared with those of 70 patients who underwent open radical nephrectomy.RESULTS No significant differences were found in operating time, complication rates, or transfusion rates between the HALS and open groups. The estimated blood loss was significantly less in the HALS group. The median follow-up period was 41.0 months for the HALS group, significantly shorter than that for the open group (74.5 months). The 3 and 5-year disease-free survival rate for the HALS and open groups was 94% and 92% and 93% and 91%, respectively. The 3 and 5-year cancer-specific survival rate for the HALS and open groups was 96% and 92% and 98% and 94%, respectively. No significant differences were found in the disease-free and cancer-specific survival rates between the two groups. In the HALS group, no significant differences were found in the disease-free survival rate between those undergoing surgery by less-experienced surgeons who had performed laparoscopic nephrectomy on 10 cases or less and those undergoing surgery by more experienced surgeons.CONCLUSIONS The oncologic outcome of HALS did not differ much from that of the open approach. Also, the experience of the surgeon did not affect the oncologic outcome. However, extended follow-up is necessary to assess the true oncologic efficacy of HALS. (c) 2007 Elsevier Inc.