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황태곤,김상훈,서성일,채수정,김준철 대한비뇨의학회 2004 Investigative and Clinical Urology Vol.45 No.5
We report our initial experience of a laparoscopic nephron sparing surgery through retroperitoneal and transperitoneal approaches. One patient with a renal tumor for each approach underwent operations. Cooling technique was not used in either cases and an occlusion of the renal artery with laparoscopic bulldog clamp was performed in the second case. Complete removal of the renal tumor was achieved in both cases. Bleeding control and repair of the collecting system with watertight sutures were successful. The operative time was 2 h and 40 min, 4 h and 5 min in each, warm ischmic time was 15 min in the second case. The hospital stay was for 4 and 8 days. The final pathologic evaluation was for lipoma and renal cell carcinoma(3.5x3.5cm in size) with a negative surgical margin. A laparoscopic nephron sparing surgery is quite feasible and might be offered as an advantage over open surgery with regards to the length of hospital stay, convalescence time and cosmetic results with more experience. But, further long term follow-up for laparascopic nephron sparing surgery might be necessary. (Korean J Urol 2004;45:485-490)
복강경하 근치적 방광적출술과 Ileal W-neobladder
황태곤,서성일,김상훈,양조환,임필빈,김준철 대한비뇨의학회 2004 Investigative and Clinical Urology Vol.45 No.6
We report our initial experience with laparoscopic radical cystectomy of an orthotopic neobladder. A 68 years old male patient with muscle invasive, organ confined, and transitional cell carcinoma of the bladder underwent operation. The operation specimen was extracted through the 5 cm sized, muscle splitting incision in the umbilical trocar site. The urinary diversion was achieved by ileal W-neobladder through a removal site of a specimen. The orthotopic neobladder was sutured to the urethra intracorporeally. Operation time and blood loss were 11 hours and 450 ml, respectively. The patient was discharged on the 14th postoperative day. Laparoscopic radical cystectomy, which involves the orthotopic neobladder creation, is feasible, although difficult and technically demanding. With growing experience, laparoscopic radical cystectomy can be an alternative to open technique.(Korean J Urol 2004;45:606-609)