Related Experiment Videos
Laparoscopic partial nephrectomy for renal tumor: Nagoya experience
Yoko Yoshikawa1, Yoshinari Ono, Ryohei Hattori
1Department of Urology, Nagoya University Graduate School of Medicine, Nagoya City, Aichi, Japan.
Urology
|August 11, 2004
Summary
A vascular clamp is indicated during laparoscopic partial nephrectomy for small renal tumors when the parenchyma between the tumor and renal sinus is less than 1 cm thick. This minimally invasive approach preserves renal function.
Area of Science:
- Urology
- Surgical Oncology
Background:
- Laparoscopic partial nephrectomy (LPN) is a minimally invasive technique for small renal tumors.
- Determining the optimal surgical strategy, including the use of vascular clamping, is crucial for successful outcomes.
Purpose of the Study:
- To clarify the indications for using a vascular clamp during LPN.
- To evaluate the clinical outcomes of LPN for small renal tumors.
Main Methods:
- A retrospective review of 17 patients who underwent LPN for small renal tumors.
- Vascular clamping was employed in 8 patients with <1 cm parenchyma between tumor and renal sinus.
- Alternative hemostatic methods were used in 9 patients with ≥1 cm parenchyma.
Main Results:
- Successful LPN was achieved in 16 of 17 patients; one conversion to open surgery due to bleeding.
- Complete tumor removal with negative margins and preserved renal function in all patients.
- Average operative time was 4.5 hours; average blood loss was 301 mL. Ischemic time averaged 25 minutes in the clamped group.
Conclusions:
- Laparoscopic partial nephrectomy is a nephron-sparing and minimally invasive procedure.
- A vascular clamp is indicated in LPN when the renal parenchyma thickness between the tumor and the renal sinus or calices is less than 1 cm.