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タイトル: | 無阻血・無縫合ロボット支援腎部分切除術の初期経験 |
その他のタイトル: | Off-Clamp, Non-Renorrhaphy Robot-Assisted Partial Nephrectomy : An Initial Experience in a Single Institution |
著者: | 土肥, 洋一郎 牧田, 哲幸 鈴木, 一生 鈴木, 良輔 久保田, 聖史 杉野, 善雄 井上, 幸治 川喜田, 睦司 |
著者名の別形: | Tohi, Yoichiro Makita, Noriyuki Suzuki, Issei Suzuki, Ryosuke Kubota, Masashi Sugino, Yoshio Inoue, Koji Kawakita, Mutsushi |
キーワード: | Robot-assisted partial nephrectomy Off-clamp Non-renorrhaphy |
発行日: | 31-Aug-2018 |
出版者: | 泌尿器科紀要刊行会 |
誌名: | 泌尿器科紀要 |
巻: | 64 |
号: | 8 |
開始ページ: | 323 |
終了ページ: | 327 |
抄録: | We report the surgical procedures and perioperative outcomes of off-clamp, non-renorrhaphy robotassisted partial nephrectomy (RAPN) in 7 out of 76 patients who underwent RAPN with off-clamp and nonrenorrhaphy between February 2015 and August 2017. The approach was chosen depending on the location of the tumor. Tumor enucleation was performed by using sharp incision and blunt dissection. For hemostasis, the soft-coagulation system was used and TachoSil○R was placed on the resection bed. As a rule, renorrhaphy was not performed. Median (range) patient age was 67 years (40-79), tumor size ; 14 mm (12-18), operative time ; 139 minutes (102-166), console time ; 51 minutes (41-75), estimate blood loss ; 10 ml (0-100). No patients required a perioperative blood transfusion. Median (range) tumor intraparenchymal depth was 10.4 mm (4.3-15.5) and distance from urinary collecting system was 9.3 mm (4.1-13.0). Pseudoaneurysm and urine leakage were not observed. No complications classified as Clavien-Dindo grade higher than grade 1 appeared. No cases had a positive surgical margin. Median (range) estimated glomerular filtration rate (eGFR) change rate at 3 months after surgery was 0% (−12.7-14.5). Off-clamp, non-renorrhaphy RAPN with the soft-coagulation system and TachoSil® is a feasible and safe procedure for patients carefully selected among those with superficial tumors. |
著作権等: | 許諾条件により本文は2019/09/01に公開 |
DOI: | 10.14989/ActaUrolJap_64_8_323 |
URI: | http://hdl.handle.net/2433/234823 |
PubMed ID: | 30369220 |
出現コレクション: | Vol.64 No.8 |
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