マイクロ波組織凝固装置を用いた腎腫瘍核出術の経験

Abstract

マイクロ波組織凝固装置(OT-110M)を用いた腎腫瘍核出術を施行した5症例7腫瘍を対象に臨床的検討を行った.7腫瘍は全て偶発癌であり, CRP, 血沈等acute phase reactantも前例正常であったが, 1例のみ免疫抑制蛋白が高値を示していた.又, 腫瘍径は対側腎機能正常例では全例4cm以下であった.平均手術時間は241分, 平均出血量は788mlで1例のみ輸血を行った.術後合併症は, 尿漏1例, 術後イレウス1例を認めた.病理組織所見は全例腎細胞癌であった.予後は最長1年6ヵ月の経過観察中で全例に再発は認めず, 現在も経過観察中である.又, 術後腎機能も全例術前とほぼ変化なく良好である

We report our clinical findings on 7 tumors in 5 patients who underwent successful enucleation of renal tumor with a microwave tissue coagulator. All patients presented with incidentally-found renal tumor on ultrasonography or computed tomography. One patient had bilateral renal tumors. The mean size of the renal tumor was 2.5 cm (Range 1.0-5.2 cm). One patient had a tumor larger than 5 cm, and was found to have renal insufficiency preoperatively. Four cases were clinically diagnosed as T1aN0M0. In all patients, the renal tumor was enucleated with a microwave tissue coagulator successfully without renal pedicle clamping. The mean operative time and blood loss were 241 minutes and 788 ml, respectively. The pathological diagnosis was renal cell carcinoma in all cases. Although 2 patients had preoperative renal insufficiency, there were no serious postoperative complications and no evidence of loss of renal function as a result of this operation. Our findings suggest that renal tumors can be enucleated with a microwave tissue coagulator safely and successfully without damaging renal function.