비뇨기계에서 단일통로 복강경 수술의 임상 경험

Abstract

Purpose : To report an initial clinical urologic experience and perioperative outcomes using single-port laparoscopic surgery Material and methods : Between June 2009 and February 2010, we performed sinlge-port laparoscopic surgery in 16 pateints for various indications including radical nephrectomy (n=5) , nephroureterectomy (n=2), simple nephrectomy (n=6), renal cystectomy (n=3).. Patients were followed postoperatively for evidence of adverse events. The parameters analyzed were body mass index, operative time, estimated blood loss, visual analogue pain score, resumption of oral intake, length of hospital stay, complications. Patient who single-port laparoscopic surgery were matched for age, surgical indication, tumor size and location, body mass index via a statiscally generated selection of all conventional laparoscopic surgery. Results : Single-port laparoscopic urologic surgery were completed in 15 of 16 patients Mean operation time was 228, 250, 185, 64 minutes for radical nephrectomy, nephrouerterectomy, simple nephrectomy and renal cystectomy respectively and blood loss was 160, 400, 194, 33 mL and post-operative hospital stay was 3.6, 6, 4, 2.3 days respectively. 1 case of simple nephrectomy was converted to open surgery because of bleeding. No major postoperative complications were reported. No significant differences in the mean operative time, blood loss, postoperative pain, postoperative hospital stay were observed between single-port laparoscopic surgery and conventional laparoscopic surgery group. Conclusion : The single-port laparoscopic urologic surgery is technically feasible, effective, offers improved comesis and high patient satisfaction in our experience. Prospective comparative study with conventional laparoscopic surgery is necessary to confirm these potential benefits.