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Related Experiment Videos

Laparoscopic heminephrectomy for tumor.

Antonio Finelli1, Inderbir S Gill, Mihir M Desai

  • 1Section of Laparoscopic and Minimally Invasive Surgery, Glickman Urological Institute, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.

Urology
|March 23, 2005
PubMed
Summary

Laparoscopic heminephrectomy, a significant renal parenchyma resection, can be safely performed for larger tumors. This advanced laparoscopic technique offers outcomes comparable to less extensive partial nephrectomies.

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Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Surgical Oncology

Background:

  • Laparoscopic partial nephrectomy is typically used for small, exophytic renal tumors.
  • Experience has expanded to include more extensive resections for larger, centrally located, or deeply infiltrating tumors when indicated.

Purpose of the Study:

  • To present the authors' experience with laparoscopic heminephrectomy, defined as excision of 30% or more of the renal parenchyma.
  • To compare outcomes of laparoscopic heminephrectomy with less extensive laparoscopic partial nephrectomy.

Main Methods:

  • A retrospective review of 41 patients who underwent laparoscopic heminephrectomy (group 1) between August 1999 and the study period.
  • A control group of 41 consecutive patients who underwent laparoscopic partial nephrectomy (less than 30% resection) was identified for comparison (group 2).

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Main Results:

  • Laparoscopic heminephrectomy patients had larger, more centrally located, and deeply infiltrating tumors compared to the partial nephrectomy group.
  • Despite longer warm ischemia times in the heminephrectomy group, operative time, blood loss, analgesic requirements, hospital stay, complications, and postoperative creatinine levels were comparable.
  • All surgical margins were negative in both groups.

Conclusions:

  • Laparoscopic heminephrectomy is an advanced yet efficacious procedure for selected patients with larger renal tumors.
  • The outcomes of laparoscopic heminephrectomy are equivalent to those of less substantial laparoscopic partial nephrectomies.
  • This study represents one of the first descriptions of laparoscopic heminephrectomy experience in the literature.