LAPAROSCOPIC SURGERY FOR UROLOGICAL CANCERS : RESEARCH INTO ITS EFFICACY AND SAFETY

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To establish effective and safe laparoscopic surgeries for urological cancers, this study developed the following procedures. First, useful laparoscopic procedures for urogenital malignancies were developed, including a partial nephrectomy for renal cancer, a nephroureterectomy for renal, pelvic and ureteral cancers, a radical prostatectomy for prostate cancer, and a total cystectomy with ileal neobladder formation and partial cystectomy for bladder tumors. According to the results from animal experiments using cancer cell implantation and RT-PCR analysis of the cancer cells in pre- and post-operative blood sampling, the risk of dissemination of the cancer cells by a pneumoperitoneum was limited. The pneumoperitoneum had limited effects on cardiac function when blood BNP was analyzed pre- and post-operatively. According to clinical parameters including post-operative recovery and wound pain, laparoscopic surgery is less invasive than open surgery. As biochemical parameters of surgical invasiveness, the serum levels of IL-6 on post-operative day 1, and post-operative decreases in the serum T3 and CH50 levels were demonstrated. In the radical nephrectomy and prostatectomy, the laparoscopic surgeries were considered to be less invasive than open surgeries according to these biochemical parameters.