Volkan TUĞCU, Alper BİTKİN, Ekrem SÖNMEZAY, Hakan POLAY, Ali İhsan TAŞÇI

4 cm’den büyük renal hücreli kanserde laparoskopik parsiyel nefrektomi

Amaç: Laparoskopik parsiyel nefrektomi yaygın olarak 4 cm’den küçük renal tümörler için uygulanır. Bu çalışmada 4 cm’den büyük renal tümörlerde transperitoneal laparoskopik parsiyel nefrektomi uyguladığımız 13 vakanın sonuçlarını sunuyoruz.Gereç ve Yöntemler: Mart 2008 – Kasım 2011 tarihleri arasında 4 cm’den büyük renal tümörlü 13 hastaya laparoskopik parsiyel nefrektomi uygulandı. Ortalama yaş 59,4 . Hastaların 7’si erkek, 6’i kadın idi. Tüm hastalara transperitoneal yaklaşım uygulandı. Operasyon sonrası 6.ay ve daha sonra yıllık olarak hastalara Abdominal BT ve Akciğer grafisi/ Toraks BT çekildi.Bulgular: Ortalama tümör boyutu 5 cm. Otalama sıcak iskemi süresi 29,3 dk, operasyon süresi ise 205 160 – 255 dk olarak ölçüldü. 4 hastada toplayıcı sistem açıldı. Ortalama kan kaybı miktarı 295 210 – 420 ml. Hastanede kalış süresi ortalama 4,7 3–9 gün. 13 hastanın patoloji sonucu renal hücreli karsinom olarak geldi 9’u berrak hücreli, 3’si papiller hücreli, 1’i kromofob hücreli . Bütün hastalarda cerrahi sınırı negatif geldi. Takiplerde hiçbir hastada lokal rekürrens veya uzak metastaz görülmedi.Sonuç: Bizim başlangıç deneyimlerimize göre 4 cm’den büyük tümörlerde laparoskopik parsiyel nefrektomi güvenli ve uygulanabilir bir tekniktir. Bununla birlikte bu sonuçların doğrulanabilmesi için daha uzun süre takip edilen çalışmalar gerekmektedir

Anahtar Kelimeler:

Büyük renal tümör, laparoskopi, parsiyel nefrektomi

Laparoscopic partial nephrectomy for renal tumors larger than 4 cm

Objective: Laparoscopic partial nephrectomy LPN is most commonly performed for renal tumors

Keywords:

Laparoscopy, large renal tumor, partial nephrectomy,

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