腹腔鏡部分腎臟切除對年紀≧65歲併多重共病的老人的可行性
張殷綸1、林威宇1、邱國雄1、陳昭安1、黃國財1
、林健煇1、黃雲慶1、何東儒1、陳志碩1、楊紫馨1
1嘉義長庚紀念醫院外科部泌尿外科
Laparoscopic Partial Nephrectomy in the elder ( age>65 y/o ) with multiple morbidities
Yin-Lun Chang1, Wei-Yu Lin1, Chih-Shou Chen1, Kuo-Cai Huang1, Jian-Hui Lin1, Yung-Chin Huang1, Dong-Ru Ho1, Chih-Shou Chen1, Kuo-Hsiung Chiu1 and Tzu-Hsin Yang1
1Division of Urology, Department of Surgery, Chiayi Chang Gung Memorial Hospital
Purpose: Laparoscopic partial nephrectomy (LPN) is the standard treatment for localized tumors nowadays. The objective of this study is to compare perioperative and postoperative outcome between young and old patients in LPN.
Materials and Methods: A retrospective analysis was performed in a total of 20 patients from 2013 to 2016. We analysis the retrospective data, including age, ASA classification, tumor size, tumor location, estimated blood loss, length of hospital stay, recurrence rate, renal function deterioration rate, 30-days mortality rate and 90 days mortality rate. We separate 20 patients into the older group (age≧65 N=7) and younger group (age<65 N=13).
Results: The tumor location were 15 in upper or lower pole, 5 in central pole. The section margin was free of malignancy in 20 patients except one patient with capsule rupture. The significant difference between the older and younger group were mean age (70.8 vs 55.2 yrs); tumor size (2.8 vs 3.5cm); estimated blood loss (231 vs 355 ml) and ASA classification≧3 rate (71.4% vs 30.7%). However, the open conversion rate, 30-day and 90-day mortality rate are all zero in both groups. Overall, there was no significant difference in length of hospital stay (13.4 vs 11.5 days), renal function deterioration rate (14.2% vs 15.3%), recurrence rate (till now all zero), mortality rate (till now all zero) between these the two groups.
Conclusion: Laparoscopic partial nephrectomy was feasible and safe in old age (age≧65) with multiple morbidities.