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三级肿瘤中心腹腔镜肾切除术的初步经验:142例病例分析

Initial Experiences of Laparoscopic Nephrectomy in a Tertiary Oncology Center: An Analysis of 142 Cases.

作者信息

Duvarcı Mehmet, Ceylan Oğuzhan, Beyatlı Murat, Uzel Tuncel, Öztürk Erdem, Hamidi Nurullah, Başar Halil

机构信息

Urology, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, TUR.

Urology, Umraniye Training and Research Hospital, Sakarya, TUR.

出版信息

Cureus. 2024 Apr 30;16(4):e59382. doi: 10.7759/cureus.59382. eCollection 2024 Apr.

Abstract

INTRODUCTION

Kidney tumors have an important place among urological malignancies. The increased utilization of imaging methods has led to a rise in renal cell carcinoma (RCC) diagnoses, albeit with declining mortality rates, particularly in developed countries. Radical nephrectomy remains the gold standard treatment. The aim of this study was to share a tertiary oncology hospital's initial experiences with laparoscopic nephrectomy.

MATERIALS AND METHODS

This retrospective study analyzes data from patients who underwent laparoscopic nephrectomy, focusing on demographic characteristics, tumor features, and operative outcomes. Information regarding age, gender, tumor size, operative details, and pathology results was collected and analyzed.

RESULTS

One hundred forty-two patients were included in the study; 69 (48.60%) were female and 73 (51.40%) were male. The mean age of the patients was 57.11 ± 12.6 years, with tumors primarily located on the left kidney (52.80%). The mean tumor size was 53.01 ± 24.01 mm. Intraoperative complications included the need for conversion to open surgery in five cases and vascular, pneumothorax, or duodenal injuries in a subset of patients. However, postoperative complications, such as sepsis or mortality, were not observed.

DISCUSSION

Despite an initial learning curve associated with longer operation times, laparoscopic techniques offer benefits, including reduced blood loss, faster recovery, and improved cosmetic outcomes. Histologically, clear cell RCC was the most common tumor type encountered. This study underscores the safety and efficacy of laparoscopic radical nephrectomy, advocating for its widespread adoption while emphasizing the importance of surgeon experience and patient selection in optimizing outcomes.

摘要

引言

肾肿瘤在泌尿系统恶性肿瘤中占据重要地位。尽管死亡率呈下降趋势,尤其是在发达国家,但影像学检查方法的使用增加导致肾细胞癌(RCC)的诊断率上升。根治性肾切除术仍然是金标准治疗方法。本研究的目的是分享一家三级肿瘤医院腹腔镜肾切除术的初步经验。

材料与方法

这项回顾性研究分析了接受腹腔镜肾切除术患者的数据,重点关注人口统计学特征、肿瘤特征和手术结果。收集并分析了有关年龄、性别、肿瘤大小、手术细节和病理结果的信息。

结果

142例患者纳入本研究;69例(48.60%)为女性,73例(51.40%)为男性。患者的平均年龄为57.11±12.6岁,肿瘤主要位于左肾(52.80%)。平均肿瘤大小为53.01±24.01mm。术中并发症包括5例需要转为开放手术,部分患者出现血管、气胸或十二指肠损伤。然而,未观察到术后并发症,如败血症或死亡。

讨论

尽管与较长的手术时间相关存在初始学习曲线,但腹腔镜技术具有诸多益处,包括减少失血、更快恢复和改善美容效果。组织学上,透明细胞RCC是最常见的肿瘤类型。本研究强调了腹腔镜根治性肾切除术的安全性和有效性,主张广泛采用该手术,同时强调外科医生经验和患者选择在优化手术效果方面的重要性。

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