マイクロ波凝固装置（マイクロターゼ）を用いた腹腔鏡下腎部分切除術の有用性と適応

Abstract

The feasibility and indication of laparoscopic partial nephrectomy for small, organ confined renal cell carcinoma (RCC) was discussed. From October 1999 to April 2004, 10 patients, who were defined as “elective” cases with normal ipsilateral kidney, underwent laparoscopic partial nephrectomy in our institute. All procedures were performed transperitoneally without clamping renal vessels. Renal parenchyma was resected with bipolar forceps in first 4 cases. In last 6 cases, microwave tissue coagulator (Microtaze®) was utilized for coagulating renal parenchyma around the tumor prior to transaction with scissors. All procedures were completed successfully without open conversion and no major complication was observed. Estimated blood loss was significantly decreased in last 6 cases in which Microtaze® was used than initial 4 cases (104.2 mL vs.1,586.2 mL). Our data indicate that Microtaze® is a useful tool for laparoscopic partial nephrectomy with superior capability of hemostasis. However, to reduce some reported complications, such as postoperative urine leakage and excessive renal infarction, critical selection of the patients should be important.