臨床泌尿器科70巻8号

2016年07月発行

綜説

家族性腎癌に対する手術治療

著者： 逢坂公人¹ 横溝由美子¹ 蓮見壽史¹ 林成彦¹ 槙山和秀¹ 近藤慶一¹ 中井川昇¹ 矢尾正祐¹

所属機関： ¹横浜市立大学附属病院泌尿器科

ページ範囲：P.565 - P.572

文献概要

要旨

　家族性腎癌はまれではあるが，両側性または多発性に発症する．治療の中心は腎温存手術であるが，腎機能維持の点から多くの症例に対し腫瘍核出術が推奨される．また，一度の手術で複数の腫瘍を切除することもまれではなく，阻血は可能な限り行わないことが望ましい．再度の手術が必要になる可能性があるため，腎門部操作を最低限に留めること，Gerota筋膜は手術終了時には修復することで術後の癒着を軽減させる．家族性腎癌は生涯にわたりフォローアップが必要となり，治療介入時期の判断も含めた正確な診断と外科的技術が求められるだけでなく，治療による腫瘍の制御と腎機能温存のバランスを保つことが求められる．

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