Gasless hand-assisted retroperitoneoscopic nephroureterectomy.
Hao Lun Luo1, Chih Hsiung Kang, Po Hui Chiang
1Department of Urology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Journal of Endourology
|January 3, 2009
Summary
Gasless hand-assisted retroperitoneoscopic nephroureterectomy (HARNU) is effective and safe, showing no significant differences in outcomes compared to traditional HARNU. Obesity did not negatively impact operative time or blood loss in this study.
Area of Science:
- Urology
- Minimally Invasive Surgery
- Surgical Oncology
Background:
- Retroperitoneoscopic nephroureterectomy (HARNU) is a standard procedure for upper tract urothelial carcinoma.
- The use of a hand port in HARNU has been debated, with potential benefits and drawbacks.
Purpose of the Study:
- To evaluate the efficacy and safety of gasless hand-assisted retroperitoneoscopic nephroureterectomy (HARNU).
- To compare outcomes between gasless HARNU and traditional HARNU with a hand port.
Main Methods:
- A study of 54 patients undergoing HARNU, divided into groups with and without a hand port.
- Further subgroup analysis based on body mass index (BMI) > 24 kg/m(2).
- Comparison of operative times, blood loss, and hospital stay between groups.
Main Results:
- No open surgery conversions were required.
- One patient experienced urine leakage requiring re-operation.
- No statistically significant differences in operative time, blood loss, or hospital stay were observed between gasless and traditional HARNU groups.
- BMI did not significantly affect surgical outcomes in either group.
Conclusions:
- Gasless HARNU is a viable and safe alternative to traditional HARNU, eliminating the need for a hand port.
- Obesity does not appear to increase operative time or blood loss in gasless HARNU.
- This technique offers a safe alternative for nephroureterectomy.
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