[Laparoscopic partial nephrectomy].

Abstract:

OBJECTIVES:To analyze the surgical and oncologic outcome of prospective experience with laparoscopic partial nephrectomy. We describe the surgical technique and mid term oncological results achieved. MATERIAL AND METHODS:60 patients were operated with this technique between June 2005 and June 2009. The mean age of patients was 58.9 [38-77] years, being 40 (66.7%) males and 20 (33.3%) women. The average BMI was 26.8 [18-40]. Laterality was 28 (46.7%) tumors rights and 32 (53.3%) left, being located in the upper pole in 14 (23.3%) patients, in the middle third in 13 (21.7%) in the lower pole in 22 (36.7%) and hiliar region in 11 (18.3%). In 23 cases (38.3%) tumors were located in the anterior valve, in 24 (40%) in posterior valve, in 10 (16.7%) at the outer edge and 3 (5%) at the inner edge. The average size tumor on CT was 3.3 [1-6.4] cm and in the surgical specimen 3.1 [1.2-7] cm. RESULTS:The mean operative time was 107.17 [50-185] min, with a warm ischemia time of 33 [0-70] min. In 56 cases (93.3%) had a single artery and 4 (6.7%) cases had 2 arteries. The artery was clamped alone in 15 patients (25%), artery and vein in 44 (73.3%) and no clamping was performed in 1 (1.7%). We repaired the urinary tract in 32 patients (53.3%), leaving ureteral catheter in all patients. 20% of patients (12) required transfusion. Intraoperative complications occurred in 5 patients (8.7%). These were: 1 splenic injury requiring splenectomy (1.7%), 1 tear in the vena cava, sutured laparoscopically (1.7%) and 3 cases of bleeding due to bulldog malfunction (5%). Postoperative complications occurred in 11 patients (18.7%) and these were: 1 wall hematoma that required reoperation (1.7%), 1 urinary fistula ending in renal atrophy and subsequent nephrectomy (1.7%), 3 intracavitary hematomas hich resolved conservatively (5%), 1 arteriovenous fistula that needed embolization (1.7%), 1 urinoma that was resolved with percutaneous drainage (1.7%) and 3 cases of postoperative fever (5%). Margins were positive in 1 patient (1.7%). In 49 cases (81.7%) histology was renal cell carcinoma, in 8 (13.3%) oncocytoma, in 2 (3.3%) angiomyolipoma and 1 (1.7%) metastasis. The average stay was 5 [3-29] days. Median follow up was 31 [12-61] months. There was a local recurrence at 16 months (hiliar primary tumor 2.5 cm) and an ipsilateral adrenal metastasis at 34 months (primary tumor 5.6 cm in left lower pole). CONCLUSIONS:In this series of laparoscopic partial nephrectomy low rate of complications, good oncologic results and low recurrence rate in the short term are shown. More patients and further monitoring is required to strengthen the functional and oncological outcomes of this surgical technique.

journal_name

Actas Urol Esp

authors

Cáceres F,Núñez-Mora C,Cabrera PM,García-Mediero JM,García-Tello A,Angulo JC

doi

10.1016/j.acuro.2011.03.015

subject

Has Abstract

pub_date

2011-09-01 00:00:00

pages

487-93

issue

8

eissn

0210-4806

issn

1699-7980

pii

S0210-4806(11)00189-6

journal_volume

35

pub_type

杂志文章
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    doi:

    authors: Puyol Pallas M,Martín Jaurena S,Juan Pereira L,Donaire Pastor F,Gómez Parada J

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  • Prostate cancer, new treatment advances - immunotherapy.

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    pub_type: 杂志文章,评审

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  • [Clinical and analytical parameters that might indicate a second biopsy in patient with high PSA and previously negative biopsy].

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    pub_type: 杂志文章

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  • [Extracorporeal shockwave lithotripsy (ESWL) for the treatment of bladder lithiasis. A new therapeutic option].

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    journal_title:Actas urologicas espanolas

    pub_type: 杂志文章

    doi:

    authors: Robles García JE,Rosell Costa D,Longo Areso J,Aguera Fernández LG,Isa Kroon W,Sánchez de la Muela P,Zudaire Bergera JJ,Berián Polo JM

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  • [Quantitative determination of epidermal growth factor urothelial receptor (EGFR) in superficial and invasive bladder carcinoma].

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    pub_type: 杂志文章

    doi:

    authors: Moreno Sierra J,Maestro de las Casas M,Ortega Heredia MD,Hermida Gutiérrez J,Resel Estevez L

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  • [Extraperitoneal bladder rupture caused by diverticular pathology].

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    pub_type: 杂志文章,评审

    doi:

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    pub_type: 杂志文章,多中心研究

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  • High-dose rate brachytherapy as monotherapy in prostate cancer: A systematic review of its safety and efficacy.

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  • [Renal hematomas after extracorporeal lithotripsy with the lithotriptor "lithostar multiline de Siemens"].

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  • [Bladder endometriosis. Diagnostic and treatment].

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  • Validation of the Spanish version of the questionnaire «Benefit, satisfaction and willingness to continue the treatment» in patients with overactive bladder.

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    pub_type: 杂志文章,多中心研究

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    pub_type: 杂志文章

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    pub_type: 杂志文章

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  • Preference for erectile dysfunction treatments: Assessment by means of consumers preference analysis techniques.

    abstract:INTRODUCTION:Patient preference for erectile dysfunction (ED) treatments is of great importance for satisfaction and adherence. We have assessed the usefulness of the main technique for assessing consumer preferences (conjoint analysis) to analyze preferences towards these treatments. We also assessed the influence of ...

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    pub_type: 杂志文章,多中心研究

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  • [Vasectomy through a single scrotal incision. Review of 500 cases. Technical note].

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    journal_title:Actas urologicas espanolas

    pub_type: 杂志文章

    doi:

    authors: Arango Toro O,Peyri Rey E,Rosales Bordes A,Gelabert Mas A,Iglesias Cortit L

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  • Satisfaction of patients with Peyronie's disease after plaque surgery and bovine pericardium graft.

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    pub_type: 杂志文章

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  • [Validation of the Spanish version of the "Bladder control Self-Assessment Questionnarie" (B-SAQ). A new screening instrument for lower urinary tract dysfunction].

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    pub_type: 杂志文章

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    pub_type: 杂志文章

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  • [Rigid ureteroscopy: results and complications].

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    journal_title:Actas urologicas espanolas

    pub_type: 杂志文章

    doi:

    authors: Franco Miranda E,Vigues Julia F,Tesedo Cubero X,López Costea MA,Pérez Céspedes M,Gil-Vernet Sedo A,Rodríguez Tolra J,Serrallach Mila N

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  • [Left inferior vena cava with renal cell carcinoma].

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  • [Usefulness of urine cytology for bladder carcinoma diagnosis: comparative study with biopsy].

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    pub_type: 杂志文章

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