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Kidney Transplant II: Surgical Procedure01:26

Kidney Transplant II: Surgical Procedure

279
Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
279
Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy01:26

Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy

163
Continuous Renal Replacement Therapy (CRRT) is an essential intervention for patients experiencing severe kidney dysfunction. This therapy offers a continuous mechanism for removing fluids and toxins from the bloodstream, leveraging the patient’s blood pressure to facilitate filtration through a specialized filter. This method contrasts with intermittent dialysis, providing a gentler and more consistent removal of waste products and excess fluid, which is particularly beneficial in...
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Kidney Transplant III: Nursing Management01:16

Kidney Transplant III: Nursing Management

289
Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
289
Continuous Renal Replacement Therapy01:30

Continuous Renal Replacement Therapy

735
Continuous Renal Replacement Therapy, also known as CRRT, is a procedural treatment for acute kidney injury (AKI) that gradually removes uremic toxins and fluids while maintaining acid-base balance and stabilizing electrolytes. It is particularly useful for hemodynamically unstable patients. Unlike intermittent hemodialysis, which is faster, CRRT provides a gentler approach over 24 hours, closely mimicking the function of natural kidneys. However, CRRT is not ideal for patients with...
735

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Updated: Jan 8, 2026

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軟性凝固法対ロボット支援部分腎切除術後の腎機能転帰

Ryunosuke Nakagwa1, Takahiro Nohara1, Taiki Kamijima1

  • 1Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.

Asian journal of endoscopic surgery
|December 16, 2025
PubMed
まとめ

ロボット支援部分腎切除術は、軟性凝固法支援開腹部分腎切除術と比較して腎機能をより良く保持する。ロボット支援アプローチは、術後の推定糸球体濾過率を保持する上で優れた結果を示した。

キーワード:
腎臓温存手術オフクランプロボット支援部分腎切除術軟性凝固法

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科学分野:

  • 泌尿器科学
  • 腎臓病学
  • 外科腫瘍学

背景:

  • 部分腎切除術は、腫瘍学的制御と腎機能保持のバランスをとる上で、局所腎腫瘍にとって極めて重要である。
  • 部分腎切除術中の虚血を最小限に抑えることは、腎機能を保護するための重要な外科的目標である。

主な方法:

  • 軟性凝固法支援開腹部分腎切除術(n=47)またはロボット支援部分腎切除術(n=182)を受けた229人の患者の後ろ向き分析。
  • 複数の術後時点での推定糸球体濾過率(eGFR)の変化率によって評価された腎機能。
  • 多変量線形回帰により、腎機能低下の予測因子を特定した。

結論:

  • 軟性凝固法支援開腹部分腎切除術は、虚血を回避するという理論的な利点にもかかわらず、腎機能の低下が大きかった。
  • ロボット支援部分腎切除術は、優れた腎機能保持を達成した。
  • 手術精度の向上と実質損傷の最小化が、ロボット支援による優れた結果に寄与している可能性が高い。