針對大於十公分腎臟癌使用腹腔鏡腎臟全切除手術:單一醫院經驗分享
葉志胤1、林宜佳1,2、蔡德甫1,2、莊光達、葉忠信、鄭以弘、仇光宇、陳宏恩、
何肇晏、吳子翔、朱懿柏、黃一勝1,2
新光吳火獅紀念醫院 外科部 泌尿科1; 輔仁大學 醫學系2
Minimal Invasive Radical Nephrectomy for Renal Cell Carcinoma Larger than 10cm: A Single Institution Experience
Chih-Yin Yeh1, Yi-Chia Lin1,2, Te-Fu Tsai1,2, Guang-Dar Juang, Chung-Hsin Yeh, Yi-Hong Cheng, Kuang-Yu Chou, Hong-En Chen, Cho-Yen Ho, Tzu-Hsiang Wu , Yi-Bo Chu, Thomas I.S. Hwang1,2
Division of Urology, Department of Surgery, Shin Kong WHS Memorial Hospital1
School of Medicine, Fu-Jen Catholic University2
Purpose: Minimal invasive radical or partial nephrectomy has been reported to be an effective surgical procedure for renal cell carcinoma. The post-operative wound pain significant decreased in minimal invasive procedure than traditional open nephrectomy. Herein, we report our experience on the minimal invasive radical nephrectomy for large renal cell carcinoma more than 10cm.
Material and method: From January 2016 to March 2019, 5 patients with renal cell carcinoma larger than 10cm underwent laparoscopic or Robotic-assisted radical nephrectomy in our hospital.
Result: Among the 5 patients, the average tumor size was 12.3cm (range 10.2-16.0cm). Peri-operative parameters including median operative time and blood loss were 181 minutes(range 145-230 minutes) and 440 ml(range 150-850ml). There was no intra-operative complication in all 5 patients. Pathology results showed 3 clear cell type, 1 chomophobe and 1 papillary type. The post-operative pain score was also low as 1-2 and average hospital stay was 6.8 days. There were no post-operative complications in these patients.
Conclusion: Minimal invasive radical nephrectomy for large renal cell carcinoma offers similar peri-operative parameter compared to traditional open procedure. The hospital stay and post-operative wound pain is superior in minimal invasive group. Minimal invasive radical nephrectomy is a safe and effective procedure for renal cell carcinoma larger than 10cm.