https://scholars.lib.ntu.edu.tw/handle/123456789/575487
標題: | Modified approach of hand-assisted laparoscopic nephroureterectomy for transitional cell carcinoma of the upper urinary tract | 作者: | Chen J. SHIH-CHIEH CHUEH Hsu W.-T. Lai M.-K. Chen S.-C. |
公開日期: | 2001 | 卷: | 58 | 期: | 6 | 起(迄)頁: | 930-934 | 來源出版物: | Urology | 摘要: | Objectives. To report a modified approach for hand-assisted laparoscopic nephroureterectomy (HALNU). Methods. Seven patients with localized transitional cell carcinoma of the upper urinary tract underwent unilateral HALNU. Patients were placed in a 60° oblique position during the entire procedure. Via a 7-cm Gibson incision on the lesion side, the distal ureterectomy and bladder cuff excision were done by an open method without opening the bladder. Then, with the surgeon's hand inserted into the peritoneal cavity by way of the same wound, HALNU was performed with two to three additional laparoscopic ports. The perioperative parameters were compared with those of 15 cases of conventional open nephroureterectomy. Results. Patients in the HALNU group had significantly less mean blood loss (140 versus 455 mL) and earlier resumption of oral intake (33 versus 61 hours), required fewer narcotics (38 versus 70 mg of morphine sulfate equivalent), and were discharged earlier (7.33 versus 9.1 days), with a faster convalescence to normal activity (3.7 versus 5.6 weeks; all P < 0.05). The total mean surgical time was 3.7 hours for the HALNU group. Conclusions. Our approach used the same incision to both excise the distal ureter and apply the hand-assist device. It also preserved the benefits of the minimal invasiveness of laparoscopic surgery compared with its open counterpart. ? 2001, Elsevier Science Inc. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-0035663962&doi=10.1016%2fS0090-4295%2801%2901389-9&partnerID=40&md5=6ab17755f1ca55d29ed96b16a2db64d3 https://scholars.lib.ntu.edu.tw/handle/123456789/575487 |
ISSN: | 0090-4295 | DOI: | 10.1016/S0090-4295(01)01389-9 | SDG/關鍵字: | morphine sulfate; adult; aged; article; bleeding; cancer localization; clinical article; comparative study; controlled study; convalescence; disease course; female; hospitalization; human; male; nephroureterectomy; patient positioning; priority journal; surgical technique; transitional cell carcinoma; treatment outcome; urinary tract; Aged; Carcinoma, Transitional Cell; Female; Functional Laterality; Humans; Kidney Neoplasms; Laparoscopes; Laparoscopy; Male; Middle Aged; Nephrectomy; Ureter; Urinary Bladder |
顯示於: | 醫學系 |
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