[Laparoscopic ultrasound guided partial nephrectomy]

The choice of method of surgical treatment for endophytic kidney tumors depends on the precise definition of the location and size, the extent of invasion into adjacent tissues and the type of vascularization. Intraoperative ultrasound (IOUS) in combination with 3D-CT allow to receive this information. The aim of this study was to compare the laparoscopic-assisted extracorporeal partial nephrectomy and laparoscopic partial nephrectomy with IOUS and visualization in Full HD, 3D Full HD and 4K modes.

A total of 77 patients aged 43-75 years with endophytic renal tumors were included in the study. They were undergone either extracorporeal partial nephrectomy or laparoscopic partial nephrectomy with IOUS. We compared the rate of positive surgical margins, early postoperative bleeding, de novo renal failure or aggravation of preexisting renal failure and stricture of vesico-ureteric anastomosis.

The rate of early postoperative bleeding, chronic kidney failure and pathologically-proven positive surgical margin in patients who underwent extracorporeal partial nephrectomy followed by kidney autotransplantation was 23.1%, 13.4% and 13.4%, respectively. After laparoscopic partial nephrectomy these values were 12%, 16.7% and 8.3%, respectively. The best outcomes were achieved in patients who underwent laparoscopic partial nephrectomy with IOUS and with a use of visualization in Full HD, 3D Full HD and 4K modes.