소절개창을 통한 영상보조 근치적 신절제술: 복강경하 및 개복하 근치적 신절제술과의 비교

오철규,나군호,양승철 대한비뇨의학회 2005 Investigative and Clinical Urology Vol.46 No.9

Purpose: We have retrospectively compared the surgical outcomes of 2 forms of minimal invasive surgery for the surgical treatment of renal cell carcinoma, the laparoscopic and video-assisted minilaparotomy(VAM) surgery, with the conventional open technique in performing a radical nephrectomy. Materials and Methods: Data from patients who underwent laparoscopic (n=14), VAM(n=15), and open(n=15) radical nephrectomies for renal cell carcinoma were reviewed. Laparoscopic radical nephrectomy was performed transperitoneally and VAM radical nephrectomy was performed using specially devised retractors such as piercing abdominal wall elevator and with endoscopic view using a telescope. Results: There were no significant differences among three groups undergoing laparoscopic, VAM, and open radical nephrectomies in terms of mean operative times(161 vs 160 vs 158 minutes, respectively). Time to oral intake, postoperative length of stay, amount of analgesics consumed for laparoscopic and VAM groups were not significantly different. However, these two groups significantly different from those of the open group. Complications included 1 transfusion and 1 paralytic ileus in the laparoscopic group, 1 transfusion in the VAM group, 2 transfusions and 2 paralytic ileus in the open group. Conclusions: Laparoscopic and VAM radical nephrectomy are associated with significantly less postoperative morbidity, time to oral intake, time to return to daily activity, postoperative length of hospital stay, and amount of analgesics consumed compared to conventional open radical nephrectomy. Therefore, in minimally invasive treatment of renal cell carcinoma, similar surgical outcomes can be expected whether purely laparoscopic or VAM technique for radical nephrectomy is adopted. Further prospective randomized studies are warranted.

신낭종 치료의 비용 효과 분석: 복강경 조대술과 재발로 인해 재시행한 경화요법과의 비교

오철규,김도완,이근욱,이용성,양승철,나군호 대한비뇨의학회 2006 Investigative and Clinical Urology Vol.47 No.2

부산지역 벤처기업의 실태와 활성화 전략

오철규 부산대학교 경영대학원 2000 원우회학술지 Vol.1 No.-

음경의 하이브리드 편평세포-우췌상암종

오철규,정보영,김재일,박석산,이혜경 대한비뇨의학회 2004 Investigative and Clinical Urology Vol.45 No.12

We report a rare case of hybrid squamous-verrucous carcinoma of penis that grew extensively in the glans and prepuce of a 68-year-old man. He presented himself with penile discharge and pain upon voiding. The penile glans and prepuce were eroded and replaced by a large, fungating, cauliflower-like ulcerative mass. There was no inguinal or pelvic lymph node enlargement. Partial penectomy was done and histologically, the superficial spreading type, well differentiated squamous cell carcinoma was seen with only minimal invasion of the background verrucous carcinoma with a pushing margin. There were no complications and recurrence of the tumor at 12 months after partial penectomy. (Korean J Urol 2004;45:1288-1291)

Initial Clinical Experience with Robot-Assisted Laparoscopic Partial Nephrectomy for Complex Renal Tumors

최경화,오철규,정우주,Enrique Ian S. Lorenzo,한웅규,나군호 대한비뇨의학회 2009 Investigative and Clinical Urology Vol.50 No.9

Purpose: Robot-assisted laparoscopic partial nephrectomy (RLPN) is gaining acceptance as an alternative to open partial nephrectomy and laparoscopic partial nephrectomy for small renal masses. However, it still remains a technically challenging procedure even for experienced laparoscopists. Endophytic tumors or renal hilar tumors pose an additional challenge. Materials and Methods: We reviewed the medical records of 11 patients (mean age: 49.3 years; range: 31-67 years) who underwent RLPN for small, complex renal masses including hilar tumors and endophytic tumors. RLPN was performed with the Da VinciⓇ surgical system (Intuitive Surgical, Sunnyvale, USA) with three robot arms and intraoperative ultrasonography (Tile-proⓇ System). Results: RLPN was performed successfully without complications in all cases. The mean tumor size was 3.2 cm (range, 1.1-8.0 cm). The mean operative time was 177 minutes (range, 150-260 minutes), and the mean warm ischemia time was 32 minutes (range, 25-41 minutes). The mean estimated blood loss was 177 ml (range, 50-350 ml), and the mean hospital stay was 4 days (range, 3-7 days). Pathology found four patients with clear cell type renal cell carcinoma, one with multilocular multicystic renal cell carcinoma, two with papillary type, one with chromophobe type, and three with angiomyolipoma. Conclusions: RLPN is a feasible and safe surgery for complex renal tumors. In our experiences, RLPN could be a nephron-sparing surgical option for patients with compromised renal function and it could be an alternative to open partial nephrectomy and laparoscopic partial nephrectomy for a select group of patients. Purpose: Robot-assisted laparoscopic partial nephrectomy (RLPN) is gaining acceptance as an alternative to open partial nephrectomy and laparoscopic partial nephrectomy for small renal masses. However, it still remains a technically challenging procedure even for experienced laparoscopists. Endophytic tumors or renal hilar tumors pose an additional challenge. Materials and Methods: We reviewed the medical records of 11 patients (mean age: 49.3 years; range: 31-67 years) who underwent RLPN for small, complex renal masses including hilar tumors and endophytic tumors. RLPN was performed with the Da VinciⓇ surgical system (Intuitive Surgical, Sunnyvale, USA) with three robot arms and intraoperative ultrasonography (Tile-proⓇ System). Results: RLPN was performed successfully without complications in all cases. The mean tumor size was 3.2 cm (range, 1.1-8.0 cm). The mean operative time was 177 minutes (range, 150-260 minutes), and the mean warm ischemia time was 32 minutes (range, 25-41 minutes). The mean estimated blood loss was 177 ml (range, 50-350 ml), and the mean hospital stay was 4 days (range, 3-7 days). Pathology found four patients with clear cell type renal cell carcinoma, one with multilocular multicystic renal cell carcinoma, two with papillary type, one with chromophobe type, and three with angiomyolipoma. Conclusions: RLPN is a feasible and safe surgery for complex renal tumors. In our experiences, RLPN could be a nephron-sparing surgical option for patients with compromised renal function and it could be an alternative to open partial nephrectomy and laparoscopic partial nephrectomy for a select group of patients.

요막관 선암 1례

김도완,오철규,정보영,김재일,박석산,강윤경 白中央醫療院 2004 仁濟醫學 Vol.25 No.1

Urachal adenocarcinoma is a rare genitourinary tumor with a poor prognosis. And the study is very rare that urachal adenocarcinoma was treated with partial cystectomy and adjuvant chemotherapy. We experienced a case of urachal tumor with Carcinoembryonic antigen (CEA) elevation which was treated successfully with partial cystectomy, en block excision of urachus and 5-Fluorouracil (5-FU) based chemotherapy. So we present a case of urachal adenocarcinoma and a brief review of previous literatures of urachal adenocarcinoma.

Effect of 5α-reductase inhibitors on the efficiency of thulium:yttrium-aluminium-garnet (RevoLix®) vaporesection for treating benign prostatic hyperplasia

정재승,서원익,오철규,김성철,박명찬,박상현,유지형,이찬호,김완석,박태용,민권식,정재일 대한비뇨의학회 2020 Investigative and Clinical Urology Vol.61 No.1

Purpose: Preoperative use of 5α-reductase inhibitors (5ARIs) may cause fibrosis of the prostate tissue and reduce the efficiency of thulium laser surgery for treating benign prostate hyperplasia (BPH). Thus, we investigated the effects of preoperative 5ARI use in this setting. Materials and Methods: This retrospective study examined 184 patients who underwent thulium laser surgery for BPH during 2012–2017. Patients were grouped according to their 5ARI use in order to compare their preoperative and intraoperative characteristics and subsequent outcomes. Surgical efficiency was assessed using vaporesection efficiency. The total operation time, vaporesection time and prostate volume change were measured. Results: The 5ARI+ group included 83 patients (45.1%) and the 5ARI− group included 101 patients (54.9%). There were no significant differences in the two groups' preoperative characteristics, postoperative prostate size, thulium laser energy use, or prostate volume reduction rate. However, relative to the 5ARI− group, the 5ARI+ group had a significant shorter total operative time (65.0 min vs. 70.0 min, p=0.013) and a significantly shorter vaporesection time (48.0 min vs. 54.0 min, p=0.014), which resulted in significantly higher vaporesection efficiency in the 5ARI+ group (0.66 mL/min vs. 0.51 mL/min, p<0.001). Both groups exhibit significant improvements in their quality of life score and International Prostate Symptom Score during the 12-month follow-up. Conclusions: In contrast with our expectations, the preoperative use of 5ARI increased the efficiency of thulium laser surgery for BPH. Thus, it may not be necessary to stop 5ARI treatment before performing thulium laser surgery in this setting.

Ileo-Pelvic Anastomosis and Augmentation Cystoplasty for Treatment of Encrusted Pyelitis in a Transplanted Kidney

진철,정재승,오철규,김성철,홍성우,박상현 대한비뇨의학회 2013 Investigative and Clinical Urology Vol.54 No.2

Infection stones are more likely to form after urinary diversion as the result of urinary stasis. To prevent urinary stasis due to encrusted pyelitis in a transplanted kidney,we describe an alternative a surgical treatment: ileo-pelvic anastomosis. In our patient with a transplanted kidney, the ileal conduit had previously been anastomosed end-to-side owing to renal tuberculosis with an atrophied bladder; the transplanted ureter was anastomosed to the ileum in the left lower abdomen with an ileal conduit on the opposite side. Routine check-up revealed hydronephrosis with infected pyelitis and ureteritis in the transplanted kidney. We performed ileo-pelvic end-to-end anastomosis to prevent urinary stasis by lengthening the ileal conduit and performed augmentation cystoplasty to support the atrophied bladder following tuberculosis. We suggest that this approach may be useful in similar cases.

여성요도구협착의 수술적 교정

오범석,김도완,오철규,노안식,박석산 白中央醫療院 2005 仁濟醫學 Vol.26 No.1

Objective: We describe various clinical presentations of female urethral meatal stricture, which may mimic other pelvic floor disorders and result in diagnostic delay. Diagnosis, management, and outcome results are reported Materials and Methods: We reviewed retrospectively 26 consecutive cases of female urethral meatal stricture. Patient characteristics, history, clinical presentation, symptom score, maximal flow rate, residual urine, diagnosis, management and short-term follow up are reported. Results: Mean patient age plus or minus standard deviation was 54 years. Most 21 (81%) cases were referred as diagnostic dilemmas with symptoms present for 1 month to 30 years. Mean interval between onset of symptoms to diagnosis was 5.8 years. The most common symptoms were residual urine sensation (77% of cases), frequency (54%), pelvic pain (46%), dysuria (46%), weak stream urine (27%), urgency (15%) and 17 patients (65%) have combined symptoms. 16 patients (62%) had been treated with oral and/or vaginal medication and/or psychotherapy. The female urethral meatal stricture was visible on physical examination in 21 patients (81%) and cystoscopy in 5 patients (19%). Of these visible urethral meatal stricture, 11 patients (45%) contained recurrent urinary tract infection, 9 patients (35%) contained urethral mucosal prolapse, 7 patients (27%) contained urethral diverticulum, and 3 patients (12%) contained stress urinary incontinence. 18 patients (69%) who has been treated with oral and/or vaginal medication or psychotherapy was not successfully improved. Treatment consist of urethral meatal excision and/or everted urethral mucosal excision and/or urethral diverticulum excision and/or anti-incontinence surgery when indicated. Subsequently 24 patients (92%) had improved symptom score, but 2 patient was not changed. In 9 patients new symptom developed. Conclusions: Female urethral meatal stricture have several urinary symptoms and may mimic other pelvic floor disorders. This condition should be considered in women with frequency, residual urine sensation, pelvic pain, dysuria and etc. Medical treatment is not sufficient but surgical treatment is usually simple, safe and effective in alleviation associated symptoms.

A Case of Robot-Assisted Laparoscopic Radical Prostatectomy in Primary Small Cell Prostate Cancer

김기홍,박상언,장지영,박원규,오철규,나군호 대한비뇨의학회 2010 Investigative and Clinical Urology Vol.51 No.12

Primary small cell carcinoma of the prostate is a rare and very aggressive disease with a poor prognosis, even in its localized form. We managed a case of primary small cell carcinoma of the prostate. The patient was treated with robot-assisted laparoscopic radical prostatectomy and adjuvant chemotherapy. Herein we report this first case of robot-assisted laparoscopic radical prostatectomy performed in a patient with primary small cell carcinoma of the prostate.