透析患者の腎癌に対する腹腔鏡下腎摘術の検討 : 経腹的到達法か経後腹膜的到達法か

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  • 透析患者の腎癌に対する腹腔鏡下腎摘術の検討
  • トウセキ カンジャ ノ ジンガン ニ タイスル フククウキョウ カジンテキジュツ ノ ケントウ : ケイ フクテキ トウタツホウ カ ケイ アトバラマクテキ トウタツホウ カ
  • ─経腹的到達法か経後腹膜的到達法か─

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Abstract

  Objective：We evaluated the impact of surgical approach on perioperative outcomes in patients with dialysis-dependent end-stage renal disease undergoing laparoscopic nephrectomy. <br>  Methods：We retrospectively reviewed 213 consecutive cases that received laparoscopic nephrectomy for renal cancer related to dialysis-dependent, end-stage renal disease at our hospital from January 2000 to December 2012. This cohort was assessed in terms of surgical approach by multivariate analyses. <br>  Results：The transperitoneal group had more male patients on anticoagulation, more diabetes, and more histories of abdominal surgery than patients in the retroperitoneal group. The mean preoperative duration of dialysis was longer, mean kidney weight was heavier, tumors were pathologically more advanced, and mean operation time was shorter in the transperitoneal group. Multivariate analysis showed that retroperitoneal approach and heavier kidney weight were independent factors of longer operation time. <br>  Conclusion：The transperitoneal approach may have an advantage in terms of operation time, especially for patients with heavy kidney.

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