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Laparoscopic partial nephrectomy in cold ischemia: renal artery perfusion
Günter Janetschek1, Alaa Abdelmaksoud, Fariborz Bagheri
1Department of Urology, Elisabethinen Hospital, Linz, Austria. guenter.janetchek@elisabethionen.or.at
The Journal of Urology
|December 11, 2003
Summary
This study demonstrates that laparoscopic partial nephrectomy using cold ischemia via renal artery perfusion is a safe and effective technique for treating small renal masses, including renal cell carcinoma.
Area of Science:
- Urology
- Surgical Oncology
- Minimally Invasive Surgery
Background:
- Laparoscopic partial nephrectomy (LPN) is a viable treatment for small renal masses.
- Achieving optimal surgical conditions during LPN can be challenging.
Purpose of the Study:
- To evaluate the initial experience and feasibility of LPN utilizing cold ischemia induced by renal artery perfusion.
- To assess the safety and reliability of this technique for renal cell carcinoma treatment.
Main Methods:
- A novel technique involving continuous perfusion of 4°C Ringer's lactate through the clamped renal artery was employed.
- Tumor excision was performed in a bloodless field, with subsequent repair of the collecting system and renal reconstruction.
- The study included 15 patients with renal cell carcinoma between November 2001 and March 2003.
Main Results:
- All 15 procedures were successfully completed laparoscopically.
- Mean operative time was 185 minutes, with a mean ischemia time of 40 minutes.
- No significant postoperative complications were observed, and renal parenchyma remained undamaged post-ischemia.
Conclusions:
- Incorporating cold ischemia via arterial perfusion into LPN is feasible and safe.
- This technique offers a reliable approach for laparoscopic partial nephrectomy in renal cell carcinoma cases.