Microwave tissue coagulatorを用いた腎部分切除術の合併症

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Partial nephrectomy was performed on 21 kidneys out of 20 patients using a microwave tissue coagulator. The diagnosis was renal tumor and renal stones in 16 and 4 patients, respectively. Renal tumors were less than 4 centimeters in diameter, except one patient with a tumor of eight centimeters in a single kidney.Excision of the tumors was done via the retroperitoneal approach through an lumbar oblique incision. Vascular clamping was necessary in two patients to reduce bleeding.Although urine leakage was seen postoperatively in three patients (14.3%), it ceased spontaneously at 14 and 23 days after surgery in two of them. In the other patient with a large renal tumor extending to the renal hilum, urine leakage continued for 43 days, although double J ureteral catheter was placed postoperatively.In three patients (14.3%), atrophy of the renal parenchyma occurred gradually after surgery and function was eventually lost in two of them. Diffuse renal atrophy seemed to be completed during four to six months after the surgery.Major postoperative complications using microwave tissue coagulator were the urine leakage and the renal atrophy. To avoid these complications, non-protruding or large renal tumor should be excluded for the indication. However, thermal injury to the renal parenchyma or large vessels might be sometimes difficult to predict.
特定非営利活動法人 Microwave Surgery研究会の論文