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◆要旨:透析患者の腎細胞癌に対する腹腔鏡下根治的腎摘除術の有用性・安全性を検討するために,非透析患者と比較した.対象は2003年6月~2004年11月までに当科において腎細胞癌と診断し,腹腔鏡下根治的腎摘除術を施行した透析群6例と非透析群7例である.透析群の平均手術時間と出血量はそれぞれ254分,388ml,非透析群ではそれぞれ268分,164mlであり,両群間に有意差は認めなかった.CRPやWBCの推移,歩行開始日や食事開始日,鎮痛剤使用回数,ドレーン排液量も両群間で差を認めなかった.以上のことから透析患者の腎細胞癌に対する腹腔鏡下根治的腎摘除術は安全かつ低侵襲で行うことができると考えられた.
We evaluated the efficacy and the safety of laparoscopic radical nephrectomy for renal cell carcinoma(RCC)in dialysis patients in comparison with non-dialysis patients. Between June 2003 and November 2004, six dialysis patients and seven non-dialysis patients underwent laparoscopic radical nephrectomy for the treatment of RCC. Mean operative time and estimated blood loss in the dialysis group(261 minutes and 383 ml, respectively)were not significantly different from the non-dialysis group(281 minutes and 164 ml, respectively). Comparing the two groups, no statistically significant differences were seen in postoperative parameters including CRP, WBC, drainage volume, analgesia use and oral intake. In conclusion, laparoscopic radical nephrectomy seems an effective and minimally invasive treatment for dialysis patients with renal cell carcinoma.
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