Korean J Urol.  2007 Jan;48(1):1-5. 10.4111/kju.2007.48.1.1.

Early Experience of Laparoscopic Partial Nephrectomy for Renal Tumor

• Seo IY
• Bae BJ
• Rim JS

• KMID: 1915012
• DOI: http://doi.org/10.4111/kju.2007.48.1.1

Abstract

PURPOSE: To evaluate the feasibility of laparoscopic partial nephrectomy for patients with renal tumors from our early experiences.
MATERIALS AND METHODS
Between February 2004 and February 2006, 20 patients with renal tumors underwent a laparoscopic partial nephrectomy, and of these, 15 were enrolled in our study. The mean age and body mass index of 6 male and 9 female were 55.2 years and 23.9, respectively. The mean tumor size was 4.2 cm. The operation was performed with a 4 trocar system through a transperitoneal approach. Bleeding from the renal parenchyme was controlled using sutures, argon beam coagulation, fibrin glue and cellulose meshes.
RESULTS
The laparoscopic partial nephrectomies were successfully performed in all patients. The mean operative time and transfusion rate were 180.7 minutes and 60%, respectively. In 6 patients, vascular bulldog clamps were used to remove the tumor mass, with a mean warm ischemic time of 32.5 minutes. The initiation of the postoperative oral intake and ambulation were 1.6 and 2.7 days, respectively, with a mean hospital stay of 8.8 days. Complications were detected in 2 patients, one case each of urinary leakage and an incisional hernia. Pathological examinations revealed renal cell carcinomas with negative surgical margins in 9 patients and angiomyolipomas in a further 6. There was no recurrence during the mean follow-up of 11.4 months.
CONCLUSIONS
A laparoscopic partial nephrectomy for a renal tumor can be safely performed. Although excellent perioperative outcomes were observed, long-term follow-up is still necessary to confirm theist effect on cancer control.

Keyword

Laparoscopy; Nephrectomy; Kidney neoplasms

MeSH Terms

Angiomyolipoma
Argon Plasma Coagulation
Body Mass Index
Carcinoma, Renal Cell
Cellulose
Female
Fibrin Tissue Adhesive
Follow-Up Studies
Hemorrhage
Hernia
Humans
Kidney Neoplasms
Laparoscopy
Length of Stay
Male
Nephrectomy*
Operative Time
Recurrence
Surgical Instruments
Sutures
Walking
Warm Ischemia
Cellulose
Fibrin Tissue Adhesive

Figure

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  Fig. 1 Trocar position of the right laparoscopic partial nephrectomy. (A) 12mm blunt tip trocar, (B) 5/12mm trocar, (C) 5/11mm trocar, (D) 5mm trocar.

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  Fig. 2 Renal artery (arrow) clamping with a laparoscopic bulldog clamp.

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