신세포암 환자에서 Video-assisted Minilaparotomy Radical Nephrectomy의 임상경험

Abstract

Purpose: Radical nephrectomy is a golden standard treatment for clinically localized renal cell carcinoma. To decrease postoperative pain, scar, recovery time assosiated with morbidity, we introduce video-assisted radical nephrectomy through minilaparotomy. We assessed the feasibility of this new technique and compared it with traditional open radical nephrectomy. Materials and Methods: From January 1998 to May 2002, 41 patients who underwent video-assisted minilaparotomy radical nephrectomy were compared with 42 patients who underwent traditional open radical nephrectomy. All patients were assessed for their age, mass size, operation time, blood loss, analgesic use, oral intake, full ambulation time, pathologic reports and recurrence. Results: Those of the 41 cases in whom video-assisted minilaparotomy radical nephrectomy was performed show no significant differences in the mean weight, mass size, operative time, blood loss, pathologic stage and recurrence when compared with those of the 42 cases in whom traditional open radical nephrectomy was performed. But the former group showed significant differences in the days taken to the initiation of oral intake, full ambulation (1.0 vs 2.5 days; p>0.001, 1.5 vs 3.1 days; p>0.001, respectively) and the analgesics use (62 vs 110 mg; p>0.001). Conclusions: Video-assisted minilaparotomy radical nephrectomy is a minimally invasive technique for surgery of renal cell carcinoma with many advantages over the traditional open radical nephrectomy, in that in addition to the role of removing intact organs, video-assisted minilaparotomy surgery is also regarded as the operation method to be considered with existing laparoscopic surgery.