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Feasibility of laparoscopic partial nephrectomy after previous ipsilateral renal procedures
Burak Turna1, Monish Aron, Rodrigo Frota
1Section of Laparoscopic and Robotic Surgery, Glickman Urological Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Urology
|June 27, 2008
Summary
Laparoscopic partial nephrectomy (LPN) is feasible in select patients with prior kidney surgery, offering a viable option despite potential technical challenges. Experienced surgeons can achieve successful outcomes with this minimally invasive approach.
Area of Science:
- Urology
- Minimally Invasive Surgery
- Oncology
Background:
- Previous renal surgery creates perirenal adhesions, often considered a contraindication for laparoscopic partial nephrectomy (LPN).
- Assessing the safety and efficacy of LPN in patients with a history of ipsilateral renal procedures is crucial.
Purpose of the Study:
- To evaluate the feasibility and outcomes of laparoscopic partial nephrectomy (LPN) in patients who have previously undergone ipsilateral renal surgery.
- To determine if prior renal surgery impacts the success and complication rates of LPN.
Main Methods:
- Retrospective analysis of a prospectively maintained database of 679 patients undergoing LPN for renal masses.
- Inclusion of 25 patients (3.7%) with prior ipsilateral open or percutaneous renal procedures.
- Detailed review of perioperative outcomes, including operative time, ischemia time, blood loss, and complications.
Main Results:
- LPN was technically successful in all 25 patients with previous renal surgery.
- Mean tumor size was 2.5 cm; mean warm ischemia time was 35.8 minutes.
- No open conversions or kidney losses occurred; 12% experienced minor postoperative complications.
Conclusions:
- Laparoscopic partial nephrectomy (LPN) is a feasible and safe option for select patients with a history of ipsilateral renal surgery.
- Adequate surgical experience with LPN is essential for managing the technical complexities associated with prior renal procedures.
