Abstract:
OBJECTIVES:To review our experience with intact extraction and morecellation of nephrectomy specimen, and the advantages and disadvantages of morcellation indicated by current reports. PATIENTS AND METHODS:In a previous study, 56 consecutive patients undergoing radical and simple transperitoneal laparoscopic nephrectomy were prospectively evaluated. Morcellation specimens (33) were extracted at the umbilical or lateral port sites and intact specimens (23) through an infraumbilical incision. Data were obtained on pathology, narcotic requirements, hospital stay, complications, estimated blood loss, size of renal mass based on preoperative imaging, specimen weight and extraction incision length. RESULTS:The mean incision length was 1.2 cm in the morcellation group and 7.1 cm in the intact group (P< 0.001). There were no significant differences in pain or recovery between the groups. In two cases of tumor nephrectomy, microscopic invasion of the perinephric adipose tissue in the intact specimen group were up-staged from clinical T1 to pT3a disease; there was no change in patient treatment based on this information. CONCLUSIONS:With proper technique, morcellation is safe for extracting renal tumours. The specimen can be evaluated for histology but not for pathological staging, limiting its use with transitional cell carcinoma. Port-site seeding is rare, and does not appear to be more frequent than with open nephrectomy. Although morcellation is cosmetically more desirable, there was no significant advantage in operating time, pain or duration of hospital stay. The choice od extraction method depends on the surgeon's preference and patient choice.
journal_name
BJU Intjournal_title
BJU internationalauthors
Varkarakis I,Rha K,Hernandez F,Kavoussi LR,Jarrett TWdoi
10.1111/j.1464-410x.2005.05194.xkeywords:
subject
Has Abstractpub_date
2005-03-01 00:00:00pages
27-31eissn
1464-4096issn
1464-410Xjournal_volume
95 Suppl 2pub_type
杂志文章abstract:UNLABELLED:WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: The various phenotypes of hypospadias may result from disturbances of dissimilar embryonic processes in different time windows, suggesting aetiological heterogeneity; however, only a few studies have investigated the risk factors for the different hy...
journal_title:BJU international
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journal_title:BJU international
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pub_type: 杂志文章,评审
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/bju.15194
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journal_title:BJU international
pub_type: 杂志文章,评审
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pub_type: 杂志文章
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1046/j.1464-4096.2001.01871.x
更新日期:2002-03-01 00:00:00
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pub_type: 杂志文章
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journal_title:BJU international
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doi:10.1046/j.1464-410x.2000.00547.x
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journal_title:BJU international
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1464-410X.2009.08447.x
更新日期:2009-04-01 00:00:00
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pub_type: 杂志文章,meta分析,评审
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pub_type: 杂志文章,评审
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pub_type: 杂志文章,meta分析,评审
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更新日期:2013-03-01 00:00:00
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pub_type: 杂志文章
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更新日期:2020-12-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1046/j.1464-410x.1999.00057.x
更新日期:1999-06-01 00:00:00
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pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1464-410X.2006.06208.x
更新日期:2006-06-01 00:00:00
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pub_type: 杂志文章
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更新日期:2003-11-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
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更新日期:2006-10-01 00:00:00
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pub_type: 杂志文章
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更新日期:2016-07-01 00:00:00
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pub_type: 杂志文章
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pub_type: 杂志文章
doi:10.1046/j.1464-410x.2000.00558.x
更新日期:2000-04-01 00:00:00
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pub_type: 杂志文章
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更新日期:2013-05-01 00:00:00