臨床泌尿器科64巻1号

2010年01月発行

特集 泌尿器腫瘍と機能温存手術―スタンダードテクニックとピットフォール

腎温存手術のピットフォールとわれわれの手技

著者： 近藤恒徳¹

所属機関： ¹東京女子医科大学泌尿器科

ページ範囲：P.15 - P.21

文献概要

要旨　腎部分切除は術後の慢性腎臓病（CKD）を予防することにより，動脈硬化による心血管病変の進行を明らかに抑制し，その結果非癌死を減少させ，その意義は近年注目を集めている。また癌制御も根治的腎摘と変わらないことから，小径腎癌に対する標準的治療として推奨されている。しかし，癌の確実な切除と最大限の腎機能温存という相反する2つの命題を満たす必要があり，そのためには，正常組織のマージン，切除断端の扱い，クランプ方法，クランプ時間など技術的なピットフォールを理解しておく必要がある。これらを理解することで，より質の高い腎温存手術を行うことができると考えている。

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