[Laparoscopic transperitoneal partial nephrectomy for a tumor of the upper segment]
1Department of Urology, I.I. Mechnikov North-Western State Medical University, St. Petersburg, Russia.
Urologiia (Moscow, Russia : 1999)
|January 30, 2018
Summary
The renal-rotation technique simplifies laparoscopic partial nephrectomy for dorsal upper pole kidney tumors, improving outcomes. This method facilitates tumor resection and reduces complication risks in kidney cancer surgery.
Area of Science:
- Urology
- Surgical Oncology
- Minimally Invasive Surgery
Background:
- Laparoscopic partial nephrectomy (LPN) for upper pole kidney tumors, especially dorsal ones, presents technical challenges.
- The renal-rotation technique offers a potential solution to improve accessibility and safety.
Purpose of the Study:
- To present the technique and outcomes of LPN using renal rotation for upper pole kidney tumors.
- To evaluate the feasibility and safety of this innovative surgical approach.
Main Methods:
- Retrospective analysis of 12 patients undergoing LPN with renal rotation for upper pole kidney tumors.
- The technique involves mobilizing the kidney, rotating it around its pedicular axis to bring dorsal tumors anteriorly for resection.
- Transperitoneal access was used, mobilizing the kidney, hilar vessels, and upper ureter.
Main Results:
- Successful LPN was achieved in all 12 patients.
- Mean operative time was 120 minutes, mean warm ischemia time was 14.5 minutes, and mean blood loss was 120 ml.
- Low complication rates (8.3% intraoperative, 25% postoperative) and no early oncological recurrence were observed.
Conclusions:
- The renal-rotation technique effectively facilitates LPN for dorsally located upper pole kidney tumors.
- This method minimizes intra- and postoperative complications, enhancing surgical outcomes.
- Maximum mobilization of the kidney and its vascular structures is crucial for successful implementation.
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