Journal of Yeungnam Medical Science
- Volume 16 Issue 1
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- Pages.94-100
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- 1999
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- 2799-8010(eISSN)
Clinical Experience of Nephron Sparing Surgery for Renal Tumor with a Normal Opposite Kidney
대측 신장이 정상인 신종양 환자에서 신보존수술의 임상 경험
- Lee, Jun-Young (Department of Urology, College of Medicine, Yeungnam University) ;
- Kim, Jung-Hyun (Department of Urology, College of Medicine, Yeungnam University) ;
- Lee, Kang-Min (Department of Urology, College of Medicine, Yeungnam University) ;
- Moon, Ki-Hak (Department of Urology, College of Medicine, Yeungnam University) ;
- Jung, Hee-Chang (Department of Urology, College of Medicine, Yeungnam University) ;
- Park, Tong-Choon (Department of Urology, College of Medicine, Yeungnam University)
- 이준영 (영남대학교 의과대학 비뇨기과학교실) ;
- 김정현 (영남대학교 의과대학 비뇨기과학교실) ;
- 이강민 (영남대학교 의과대학 비뇨기과학교실) ;
- 문기학 (영남대학교 의과대학 비뇨기과학교실) ;
- 정희창 (영남대학교 의과대학 비뇨기과학교실) ;
- 박동춘 (영남대학교 의과대학 비뇨기과학교실)
- Published : 1999.06.30
Abstract
The aim of this retrospective study was to determine whether a nephron sparing surgery might be feasible in patients with a small solid renal tumor. Materials and methods: Between 1988 and 1999, 21 patients with a radiologically detectable small solid renal tumor underwent enucleoresection, wedge resection and polar segmental nephrectomy. The mean age of the 11 men and 10 women in this study was 43 years (range 14 to 68). According to the preoperative radiological diagnosis, 15 among the 21 patients were considered to have renal cell carcinoma, 4 were considered to have angiomyolipoma, and in the remaining 2 patients, radiological differentiation of renal tumors was difficult. Among 15 patients considered to have renal cell carcinoma, 14 were found to have renal cell carcinoma and the remaining one patient was diagnosed as having oncocytoma on pathologic examination. Radiological determination of angiomyolipoma in four patients was confirmed to be correct on pathological examination. The 2 patients whose radiological diagnose was difficult were found to have cavernous hemangioma and angiomyolipoma. One patient with renal cell carcinoma developed arteriocaliceal fistula, the only immediate complication in this series and underwent nephrectomy on postoperative 10th day. The mean follow up duration for the 14 patients with renal cell carcinoma was 18.6 months (range:1-103). There was no other tumor involvement in the resection margins following the nephron sparing surgery. These results suggest that nephron sparing surgery provides an effective treatment for patients with a single, small, unilateral, localized renal tumor. Longer follow-up is suggested for more definite verification of the role of nephron sparing surgery.
본 연구는 신보존수술의 임상적 가치를 알아보기 위해, 반대측 신장이 기능적으로 정상인 작은 크기의 고형 신종양 환자를 대상으로 신보존수술을 이용한 환자의 임상 경과를 후향적인 조사를 통하여 알아보고자 하였다. 21례의 환자중 술전 방사선 영상 소견상 신세포암으로 추정된 15례의 환자는 술후 병리조직학적 검사 결과 14례에서 신세포암(