腎盂尿管腫瘍に対する腹腔鏡手術と開腹手術についての臨床的検討

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  • ジンウニョウカン シュヨウ ニ タイスル フククウキョウ シュジュツ ト カイフク シュジュツ ニ ツイテ ノ リンショウテキ ケントウ

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Abstract

  Laparoscopic nephroureterectomy（LNU）has been used to treat upper urinary tract urothelial cell carcinomas, We performed a retrospective review of the parasurgical parameters, and used the E-PASS scoring system to predict surgical stress in patients undergoing 70 LNU and 25 open nephroureterectomie（ONUs） from May 2000 to November 2010. The median age was 71 years for LNU, and 66 for ONU（p=0.0355）. LNU had less blood loss（median：147.5 vs. 240ml, p=0.0125）, comparable operation times（351 vs. 280 min）, lower CRP levels（5.5 vs. 8.5μg/dl, p=0.0002）, an earlier postsurgical oral intake（1 vs. 2 days, p=0.0253）and a significantly lower E-PASS score. The 5 - year survival was 69.6% for all patients, 76.3% for LNU and 50.9% for ONU （p=0.0118）. After excluding the pT4 stage patients, the survival rates became comparable between the two groups. LNU was less invasive, had a faster recovery time and the prognosis was comparable.

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