単孔式ロボット後腹膜腎尿管全摘除術と膀胱カフ切除術：多孔式経腹膜アプローチとの比較コホート研究

Seokhwan Bang¹, Dongho Shin¹, Yong Hyun Park¹

¹Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

Journal of endourology

|February 4, 2026

まとめ

単孔式（SP）ロボット腎尿管全摘除術（NUx）は実現可能であり、多孔式（MP）NUxと比較して手術時間を短縮する。この低侵襲アプローチは、尿路上皮癌治療において同等の安全性と有効性を示す。

科学分野:

泌尿器科学
癌治療
ロボット手術

背景:

尿路上皮癌の治療には、膀胱カフ切除を伴う腎尿管全摘除術（NUx）が必要である。
患者のアウトカム改善のためには、低侵襲アプローチが好まれる。

研究の目的:

膀胱カフ切除を伴う単孔式（SP）ロボット腎尿管全摘除術（NUx）の有効性と安全性を評価する。
SPロボットNUxと従来の多孔式（MP）ロボットアプローチを比較する。

主な方法:

ロボット支援腹腔鏡下NUxを受けた尿路上皮癌患者105人の後向きレビュー。
MP NUxを受けた52人の患者とSP NUxを受けた53人の患者の手術成績の比較。

主要な成果:

患者特性、コンソール時間、腎機能低下に有意差なし。
SPロボットNUxは、総手術時間を統計的に有意に短縮した（平均45分短縮）。
SPロボットNUxは、MPロボットNUxと比較して推定出血量が有意に少なかった。

結論:

膀胱カフ切除を伴う単孔式ロボット腎尿管全摘除術は、多孔式アプローチの実現可能な代替法である。
SPアプローチは、膀胱カフ切除のためのアクセス改善により、手術時間の短縮に利点をもたらす。

キーワード:

尿路上皮癌腎尿管全摘除術後腹膜単孔ロボット

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