第10,第11肋間切開による腎・副腎手術

Abstract

Kidneys and adrenals are situated in the retroperitoneal space under the costal arch. Various approaches have been devised to obtain a sufficient visual field for the operation of the organs. Supracostal approach can give an operator a broad visual field and make him to perform an operation under direct observation of the adrenal, the upper and the middle part of the kidney. The supracostal approach was adopted in 45 cases (Table 1) among 83 cases in which an operation on the kidney and the adrenal was performed during the last 2 years (Table 2 and 3). The average operation time was 125.6 minutes and the average amount of the lost blood was 326.2 ml. Blood transfusion was made in 8 cases (17.8%). As complications, there were 4 cases with pneumothorax and I case with atelectasis, due to damage of the pleura. Thus, the supracostal approach is considered to be a safe and excellent technique, as it enables an operator to perform an operation under direct observation of the object.