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Retroperitoneal Laparoscopic Partial Nephrectomy for Renal-Cell Carcinoma in a Solitary Kidney: Report of 56 Cases
- Source :
- Journal of Endourology. 23:1971-1974
- Publication Year :
- 2009
- Publisher :
- Mary Ann Liebert Inc, 2009.
-
Abstract
- The aim of this study was to evaluate the possibility and clinical efficacy of retroperitoneal laparoscopic partial nephrectomy for T(1)- and T(2)-stage renal-cell carcinoma (RCC) of a solitary kidney.A total of 56 patients with RCC in a solitary kidney were selected in this study, including 41 men and 15 women with a mean age of 49 years. B-type ultrasonography and CT revealed T(1)N(0)M(0) tumors in 51 cases and T(2)N(0)M(0) tumors in the remaining 5 cases; 41 cases were RCC in left kidney, and 15 were RCC in right kidney. Of them, 24 cases had RCC located in the upper pole, 24 in the inferior pole, and 8 in the central region of the kidney. The mean tumor diameter was 3.0 +/- 0.8 cm (1.5-5.5 cm). Postoperative pathology report showed 46 cases of T(1)-stage tumor (T(1a): 38; T(1b): 8) and 10 cases of T(2) stage. Retroperitoneal laparoscopic nephron-sparing surgery was performed. Surgical resection was performed along a resection line 0.5 cm from the tumors. Renal function was determined using emission CT before and after operation. Preoperative three-dimensional CT image reconstruction was performed using multislice spiral CT.All procedures were successfully performed without open conversion and serious complications. The mean warm ischemia time was 24 +/- 4.2 minutes (19-50 minutes). The mean operation time was 95 +/- 14.5 minutes. The mean blood loss volume was 105 +/- 20.4 mL. No postoperative urine leakage occurred. Both serum creatinine and nitrogen levels were normal after operation in all cases. The mean hospital stay was 9 +/- 2 days. There was no requirement for hemodialysis. No recurrence, metastasis, and implantation were observed during the 20 +/- 4 month follow-up periods, with a survival rate of 100%.Laparoscopic partial nephrectomy can be performed safely and effectively in selected patients with tumors in a solitary kidney owing to its minimal invasion, clear dissection, less hemorrhage, and rapid recovery.
- Subjects :
- Adult
Male
Nephrology
medicine.medical_specialty
Urology
medicine.medical_treatment
Solitary kidney
Kidney
urologic and male genital diseases
Nephrectomy
Renal cell carcinoma
Internal medicine
Carcinoma
Humans
Medicine
Retroperitoneal Space
Carcinoma, Renal Cell
Aged
business.industry
Cancer
Middle Aged
medicine.disease
Kidney Neoplasms
Female
Laparoscopy
business
Kidney cancer
Kidney disease
Subjects
Details
- ISSN :
- 1557900X and 08927790
- Volume :
- 23
- Database :
- OpenAIRE
- Journal :
- Journal of Endourology
- Accession number :
- edsair.doi.dedup.....608889b1ff20f59b7131073094165747