單孔腹腔鏡腎臟部分切除手術
李經家 1, 葉信志 1, 蔡嘉俊 1, 李香瑩 1 , 闕光瞬 1, 王怡雅1 , 溫聖辰 2 , 柯宏龍 2, 黃俊農 2,周以和2 , 吳文正 1
1 高雄市立大同醫院 泌尿科
2高雄醫學大學附設醫院 泌尿科
Laparoendoscopic single site partial nephrectomy
Ching-Chia Li 1, Hsin-Chih Yeh 1, Hsiang-Ying Lee 1, Chia-Chun Tsai 1 , Kuang- Shun Cuhch 1, Yi-Ya Wang1 , Sheng-Chen Wen 2 , Hung-Lung Ke 2, Chun-Nung Huang 2,Yii-Her Chou2 , Wen-Jeng Wu 1
1 Department of Urology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
2 Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
Abstract
Background Laparoendoscopic single site(LESS) partial nephrectomy is a technically demanding surgery. We present our results of LESS partial nephrectomy in Kaohsiung Municipal Ta-Tung Hospital and Kaohsiung Medical University Hospital.
Methods We performed LESS PN on 21 patients with localized renal parenchymal tumor (stage T1). The procedures were done from Mar. 2014 to Feb. 2017. Our technique involves the covering of renal defect layer by layer with FloSeal, Tisseel and a fat pad after mono-polar coagulation. We complete whole the procedures without perfroming intracorporeal suturing. Lagiport were used during our procedure.
Results Mean patient age was 58.5 years old (range 36-77). Mean tumor size was 2.7 cm (range 1.6-4.8). Mean RENAL nephrometry score was 5.7 (range 4-9). The average operation time was 178.1 minutes (range 100-250) and the average warm ischemic time was 12.6 minutes (range 8-26). Mean estimated blood loss was 116.6 ml (range 20-430). No recurrent tumors were identified at a mean follow-up of 13 months postoperatively. Conclusion LESS PN is a feasible surgical method for most patients with stage 1 tumor. Our technique can reduce the warm ischemic time significantly. By this technique, surgeon can perform LESS PN more easily and quickly.