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Related Concept Videos

Urinary Tract Calculi VI: Surgical Management01:25

Urinary Tract Calculi VI: Surgical Management

Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...

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5/6 Nephrectomy Using Sharp Bipolectomy Via Midline Laparotomy in Rats
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Laparoscopic partial nephrectomy for >4 cm renal masses.

Fahad A Alyami1, Ricardo A Rendon

  • 1Department of Urology, Dalhousie University, Halifax, NS.

Canadian Urological Association Journal = Journal De L'Association Des Urologues Du Canada
|June 15, 2013
PubMed
Summary
This summary is machine-generated.

Laparoscopic partial nephrectomy (LPN) for large renal masses (>4 cm) is technically challenging but shows acceptable short-term surgical outcomes. Experienced surgeons can achieve excellent results with no negative impact on renal function or blood pressure.

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Area of Science:

  • Urology
  • Surgical Oncology

Background:

  • Laparoscopic partial nephrectomy (LPN) is standard for small renal masses (cT1a).
  • Limited data exists for LPN in larger renal masses (>T1a).
  • This study reports outcomes of LPN for renal masses >4 cm.

Purpose of the Study:

  • To evaluate the safety and short-term outcomes of LPN for renal masses >4 cm.
  • To assess the impact of LPN on renal function and blood pressure in these patients.

Main Methods:

  • Retrospective review of 52 consecutive LPN cases for renal masses >4 cm (Jan 2003 - Jul 2011).
  • Data collected included demographics, pathology, and clinical outcomes.
  • Analysis of surgical time, blood loss, warm ischemia time, complications, and renal function.

Main Results:

  • Median tumor size was 4.8 cm; median surgical time was 145 minutes.
  • Complication rates included 7.7% conversion to open surgery, 7.7% urine leak, and 7.7% bleeding requiring angioembolization.
  • No significant difference in pre- and post-operative estimated glomerular filtration rate or mean arterial blood pressure.

Conclusions:

  • LPN for >4 cm renal masses is technically demanding but yields acceptable short-term surgical outcomes.
  • Excellent results are achievable in selected patients by experienced surgeons.
  • Long-term oncological outcomes require further assessment; LPN for these larger tumors is not standard of care.