マイクロ波による組織凝固を用いた無阻血腎腫瘍核出術の成績

概要

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There have been several reports supporting that nephron-sparing surgery might be accepted in the cases with small renal cell carcinoma recently. From August 1993 to December 1997, in situ non-ischemic enucleation of small renal cell carcinoma using microwave tissue coagulator (Microtaze) was performed in 28 patients (30 renal units) at Nara Medical University and its affiliated hospitals. The post operative courses were uneventful. The mean level of serum creatinine before and one month after operation were 0.94 ± 0.41 mg/dl and 0.97 ± 0.47 mg/dl, and those of creatinine clearance were 82.7 ± 43.5 ml/min and 78.9 ± 37.1 ml/min, respectively. MRI showed about 10 mm-width of ischemic bands around the resected border at one month after operation, however most of them had tendency to reduction gradually. Post operative local tumor recurrence did not occurred during follow up. These results suggested that in situ non-ischemic enucleation of small renal cell carcinoma using microwave tissue coagulator may be simple, secure and suitable for nephron-sparing surgery.