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        로봇 보조 복강경 방광적출술 및 요로전환술의 초기 경험

        조희주(Hee Ju Cho),신순철(Soon Cheol Shin),서도영(Do Young Seo),민동석(Dong Suk Min),조정만(Jeong Man Cho),강정윤(Jung Yoon Kang),유탁근(Tag Keun Yoo) 대한비뇨기종양학회 2012 대한비뇨기종양학회지 Vol.10 No.1

        Purpose: Robot assisted laparoscopic radical cystectomy (RARC) is one of the options for minimal invasive treatment of muscle invasive bladder cancer or uncontrolled non muscle invasive bladder cancer. We detailed our operative techniques and initial experiences of robot assisted laparoscopic radical cystectomy with urinary diversion. Materials and Methods: From April 2010 to December 2011, 10 consecutive patients with bladder cancer who were performed robot assisted laparoscopic radical cystectomy with urinary diversion were enrolled. Patient’s demographics, intra-, perioperative data and oncologic outcome were analyzed. Urinary diversions including 9 ileal conduit and 1 ileal orthotopic neobladder were underwent extracoporeally. Results: Mean patient age was 65.1 years. The mean body mass index was 22.7kg/m². The mean operation time was 588.1min including 319.5min for robot assisted laparoscopic cystectomy (RARC), 165.0min for extracorporeal urinary diversion and 53.1min for lymph node dissection. The mean estimated blood loss was 244.7ml. The mean number of retrieved lymph node was 17.2. The pathologic report showed transitional cell carcinoma in all cases and adenocarcinoma of prostate in 2 male patients. No intra-operative complication was occurred. Conclusions: Robot assisted laparoscopic radical cystectomy could minimize surgery related complications without jeopardizing oncologic outcome. RARC may be effective treatment option for advanced bladder cancer.

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        상부요로 요로상피암에서 Heat Shock Protein 27와 Cellular FLICE-like Inhibitory Protein의 발현

        조정만(Jeong Man Cho),조희주(Hee Joo Cho),문경태(Kyong Tae Moon),민동석(Dong Suk Min),김은경(Eun Kyung Kim),김덕윤(Duk Yoon Kim),박재신(Jae Shin Park),유탁근(Tag Keun Yoo) 대한비뇨기종양학회 2011 대한비뇨기종양학회지 Vol.9 No.2

        Purpose: We investigated the expressions of Heat shock protein 27 (HSP27) and Cellular FLICE-like inhibitory protein (c-FLIP) with urothelial carcinoma of the upper tract. Materials and Methods: The expressions of HSP27 and c-FLIP were quantified immunohistochemically form sixty one patients who underwent nephroureterectomy for urothelial carcinoma of the upper tract and 10 patient’s normal ureteral tissues who underwent nephrectomy. The overall percentage of cancer cells showing staining (0% to 100%) was indicated by visual scoring. Specimens were graded from 0 to +3 intensity representing the range of staining area, for which below 1% is 0 grade, 1-10% is+1 grade, 10-50% is +2 grade, over 50% is +3 grade. Results: HSP27 positive reaction was seen in 10 of 10 cases (100%) with a normal ureter, 59 of 61 cases (96.7%) with urothelial carcinoma of the upper tract. The mean HSP27 reaction scores were 2.67 with low grade, 2.27 with high grade (p=0.045). HSP27 expression was not statistically significant according to stage and lymph node metastasis. c-FLIP positive reaction was seen in 0 of 10 cases (0%) with normal ureter, 57 of 61 cases (93.4%) with urothelial carcinoma of the upper tract. c-FLIP expression was not statistically significant according to grade, stage and lymph node metastasis. Conclusions: This study suggests that the expression of HSP27 is reduced and the expression of c-FLIP is increased in patients with urothelial carcinoma of the upper tract. If these data are confirmed, HSP27 and c-FLIP may be usable as prognostic marker of urothelial carcinoma of the upper tract.

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