Clinical Experience of Video-Assisted Minilaparotomy Radical Nephrectomy for Renal Cell Carcinoma

Kim, Dong Jun; Rha, Koon Ho; Yang, Seung Choul

Abstract

PURPOSE: Radical nephrectomy is a golden standard treatment for clinically localized renal cell carcinomas. To decrease the postoperative pain, scar and recovery time associated with morbidity, a video-assisted radical nephrectomy, through a minilaparotomy, was introduced. The feasibility of this new technique was assessed and compared with a traditional open radical nephrectomy.
MATERIALS AND METHODS
Between January 1998 and May 2002, 41 patients that had undergone a video-assisted minilaparotomy radical nephrectomy were compared with 42 patients that had undergone a traditional open radical nephrectomy. All patients were assessed for their age, mass size, operation time, blood loss, analgesic use, oral intake, full ambulation time, pathological reports and recurrence.
RESULTS
In the 41 cases having had the video-assisted minilaparotomy radical nephrectomy no significant differences in the mean weight, mass size, operative time, blood loss, pathologic stage and recurrence were found compared with the 42 cases where a traditional open radical nephrectomy had been performed. However, the former group showed significant differences in the days taken to the initiation of oral intake, full ambulation (1.0 vs. 2.5 days; p<0.001, 1.5 vs. 3.1 days; p<0.001, respectively) and analgesics use (62 vs. 110 mg; p<0.001).
CONCLUSIONS
A video-assisted minilaparotomy radical nephrectomy is a minimally invasive surgical technique for renal cell carcinomas, with many advantages over the traditional open radical nephrectomy, because in addition to the role of removing intact organs, video-assisted minilaparotomy surgery is regarded as the operation method that should be considered with existing laparoscopic surgery.