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Title: 無阻血・無縫合ロボット支援腎部分切除術の初期経験
Other Titles: Off-Clamp, Non-Renorrhaphy Robot-Assisted Partial Nephrectomy : An Initial Experience in a Single Institution
Authors: 土肥, 洋一郎  KAKEN_name
牧田, 哲幸  KAKEN_name
鈴木, 一生  KAKEN_name
鈴木, 良輔  KAKEN_name
久保田, 聖史  KAKEN_name
杉野, 善雄  KAKEN_name
井上, 幸治  KAKEN_name
川喜田, 睦司  KAKEN_name
Author's alias: Tohi, Yoichiro
Makita, Noriyuki
Suzuki, Issei
Suzuki, Ryosuke
Kubota, Masashi
Sugino, Yoshio
Inoue, Koji
Kawakita, Mutsushi
Keywords: Robot-assisted partial nephrectomy
Issue Date: 31-Aug-2018
Publisher: 泌尿器科紀要刊行会
Journal title: 泌尿器科紀要
Volume: 64
Issue: 8
Start page: 323
End page: 327
Abstract: We report the surgical procedures and perioperative outcomes of off-clamp, non-renorrhaphy robotassisted partial nephrectomy (RAPN) in 7 out of 76 patients who underwent RAPN with off-clamp and nonrenorrhaphy between February 2015 and August 2017. The approach was chosen depending on the location of the tumor. Tumor enucleation was performed by using sharp incision and blunt dissection. For hemostasis, the soft-coagulation system was used and TachoSil○R was placed on the resection bed. As a rule, renorrhaphy was not performed. Median (range) patient age was 67 years (40-79), tumor size ; 14 mm (12-18), operative time ; 139 minutes (102-166), console time ; 51 minutes (41-75), estimate blood loss ; 10 ml (0-100). No patients required a perioperative blood transfusion. Median (range) tumor intraparenchymal depth was 10.4 mm (4.3-15.5) and distance from urinary collecting system was 9.3 mm (4.1-13.0). Pseudoaneurysm and urine leakage were not observed. No complications classified as Clavien-Dindo grade higher than grade 1 appeared. No cases had a positive surgical margin. Median (range) estimated glomerular filtration rate (eGFR) change rate at 3 months after surgery was 0% (−12.7-14.5). Off-clamp, non-renorrhaphy RAPN with the soft-coagulation system and TachoSil® is a feasible and safe procedure for patients carefully selected among those with superficial tumors.
Rights: 許諾条件により本文は2019/09/01に公開
DOI: 10.14989/ActaUrolJap_64_8_323
PubMed ID: 30369220
Appears in Collections:Vol.64 No.8

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