上泌尿道上皮癌開腹及腹腔鏡手術預後
潘柏諺1、張英勛1
1林口長庚紀念醫院 外科部 泌尿科系
Surgical outcomes between open and laparoscopic radical nephroureterectomy
Pai-Yen, Pan, MD1., Ying-Hsu Chang, MD.
1Divisions of Urology, Department of Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
Purpose:
To
Materials and Methods:
We collect Jan. 2007 to Dec. 2007 cases of upper tract urothelail carcinoma in Chang Gung Memorial Hospital LinKou branch. A total 102 cases of upper tract urothelial carcinoma and we excluded end stage renal disease, bilateral cancer, incomplete data, loss follow-up cases. Finally, 52 cases was enrolled. Thirty-five patients underwent open radical nephroureterectomy and 17 patients underwent laparoscopic radical nephrouretetectomy.
Results:
The analysis revealed a slightly longer operation time （291.2 vs. 223.3 mins）, a slightly longer hospital stay（10.9 vs. 10.2 days）and slightly lower blood loss（150.6 vs. 183.4）in laparoscopic group. The frequency of bladder recurrence（open vs. laparoscopic: 14.3 vs. 11.8%）, local recurrence（8.6 vs 11.8%）, distal recurrence（0 vs. 5.9%）. There was no significant difference of overall survival rate between two groups. However, male has poor overall survival than female.
Conclusions:
Open radical nephroureterectomy is gold standard for surgical treatment of upper tract urothelial carcinoma. In our studies, laparoscopic radical nephrouretetectomy seems to offer minimally invasive surgery without deteriorating oncologic outcomes.