[Laparoscopic partial nephrectomy for small renal tumors: report of 59 cases]
Lin Wang1, Hui Wang, Zhen-li Gao
1Department of Urology, Affiliated Yantai Yuhuangding Hospital of Qingdao University Medical College, Yantai 264000, China. zrt@medmail.com.cn
Objective:
To report our initial experiences of laparoscopic partial nephrectomy (LPN) for small renal tumors.
Methods:
From July 2005 to December 2008, 59 patients with small renal tumors were resected by laparoscopic partial nephrectomy.
Results:
All operations were successfully accomplished. Twenty-seven patients were treated via a transperitoneal approach and the other 32 cases a retroperitoneal approach. The average operative duration was 72 minutes (range: 60 -) and the average kidney ischemia time 19 minutes (range: 15 - 32). The estimated blood loss was from 20 - 50 ml and no patient needed transfusion. The collecting system closure was performed by suture in 2 patients, and no complication of hemorrhage or urine leak was found. Thirteen cases used Hemo-lok to clamp the suture instead of traditional ligature. And the mean time of renal warm ischemia was 13 minutes (range: 10 - 18). These patients included 55 with clear cell renal carcinoma, 3 with granule cell renal carcinoma and 1 with oxyphil cell renal carcinoma. All renal tumors were completely removed with a negative surgical margin. The mean postoperative hospital stay was 6.2 days (range: 5 - 10). The postoperative ECT and creatinine were normal and there was no significant difference as compared with the preoperative findings (P < 0.05). None patient had any local recurrence during a mean follow-up period of 24.6 months (range: 3 - 42).
Conclusions:
LPN for pT(1) stage renal tumor is both safe and feasible. Mastering the skilled laparoscopic techniques may facilitate operation. Employing Hemo-lok instead of traditional ligature to clamp the suture while sewing renal wound shortens the warm ischemia time.
