マイクロ波組織凝固装置を用いた腎部分切除術

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Recently, there have been various reports on the favorable outcomes of nephron-sparing surgery for small renal cell carcinoma, presenting its safe and reliable procedure based on the clinicopathological investigation. Between August 1993 and April 2003, partial nephrectomy for small renal cell carcinoma using microwave tissue coagulator (Microtaze® ; abbreviated as MTC) was performed in 97 patients (100 renal units) at Nara Medical University and its affiliated hospitals. In most cases except 3 patients treated with secondary nephrectomy, postoperative clinical courses were uneventful. The mean levels of serum creatinine prior to operation and that at the last examination over one month posterior to the operation were 0.87±0.19 and 1.01±0.31 mg/dL, respectively, with no significant deterioration of renal function. MRI performed at one month after the operation showed some marginal ischemic area, about 10 mm in width, around tumor-resected site, there-after with time, the ischemic area had gradually shrinked or disappered. Histopathological study revealed that MTC yielded minimum and limited necrotic change caused by heat damage around the demarcation area of coagulation. The 5-year overall-survival rate was 94% without local recurrence up to 48.8±30.3 months of the mean follow-up. Our data shows that partial nephrectomy using MTC constitutes a simple, reliable and less invasive nephron-sparing surgery for the treatment of small renal cell carcinoma.

マイクロ波組織凝固装置を用いた腎部分切除術

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