1861 KTP LASER LAPAROSCOPIC PARTIAL NEPHRECTOMY VERSUS CONVENTIONAL LAPAROSCOPIC PARTIAL NEPHRECTOMY IN ANIMALS. RANDOMIZED CONTROLLED TRIAL

Abstract

You have accessJournal of UrologyKidney Cancer: Localized1 Apr 20111861 KTP LASER LAPAROSCOPIC PARTIAL NEPHRECTOMY VERSUS CONVENTIONAL LAPAROSCOPIC PARTIAL NEPHRECTOMY IN ANIMALS. RANDOMIZED CONTROLLED TRIAL Jorge Rioja, Miguel Hurtado, Federico Soria, Angel Borque, Luis Plaza, Francisco Miguel Sanchez-Margallo, Jesus Uson, and Luis Angel Rioja Jorge RiojaJorge Rioja Zaragoza, Spain More articles by this author , Miguel HurtadoMiguel Hurtado Caceres, Spain More articles by this author , Federico SoriaFederico Soria Caceres, Spain More articles by this author , Angel BorqueAngel Borque Zaragoza, Spain More articles by this author , Luis PlazaLuis Plaza Zaragoza, Spain More articles by this author , Francisco Miguel Sanchez-MargalloFrancisco Miguel Sanchez-Margallo Caceres, Spain More articles by this author , Jesus UsonJesus Uson Caceres, Spain More articles by this author , and Luis Angel RiojaLuis Angel Rioja Zaragoza, Spain More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1908AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Laparoscopic Partial Nephrectomy is a challenging procedure. To make laparoscopic nephron sparing surgery easier multiple ablative techniques have been developed but with not as good results as partial nephrectomy. To analyze feasibility of laser KTP partial nephrectomy and compare results with conventional laparoscopic partial nephrectomy. METHODS 30 Large White female pigs were randomized to laser KTP or conventional laparoscopic partial nephrectomy. All pigs weighted 30–35 kg as its kidney size is similar to human kidney. Laparoscopic radical right nephrectomy was performed in all kidneys to make them mono-kidney and analyzed the impact of surgery in their renal function. And artificial renal tumour (plastic) was placed in the left kidney (10 upper pole, 10 mid pole and 10 lower pole). All pigs were heparinised to decrease pig coagulation mechanism and make it more similar to human. Partial nephrectomy was performed in all kidneys until collecting system, to analyzed urinary fistula after both methods. All pigs were followed up for 6 weeks in the clinic and by means of blood test after surgery, 3 weeks and at the end of the study, colour Doppler ultrasound and retrograde pyelography (pre-surgery, after surgery, 3 weeks after surgery and at the end of the study) to study renal function and healing of the urinary system. After 6 weeks all pigs were sacrificed, an autopsy was performed and pathology exam of both kidney and partial nephrectomy was performed. RESULTS All Laser KTP partial nephrectomies were performed without hiliar clamping. Suturing of the colleting system was done in all cases. Only 3 cases required parenchymal stitches for haemostasis. All conventional partial nephrectomies were performed with hiliar clamping, closing of the collecting system and parenchimal stiches with surgicel roll for haemostasis. In the KTP laser, 3 pigs died due to urinary fistula in the first week after surgery. In the conventional partial, 1 pig died due to myocardial infarction. Overall, there was no ischemia time in the laser group. Renal function 24hours after surgery was better in laser group. (p<0,000) In the laser group, there was wider fibrosis (<5 mm) in the normal parenchyma (p<0,000). There were no differences in positive surgical margin within the two groups. At the end of follow-up, there were no differences in autopsy results, by means of fibrosis, haematoma or urinoma. CONCLUSIONS Laparoscopic Laser KTP partial nephrectomy is feasible and safe in the animal model. It might be an easier alternative to Lap. conventional partial nephrectomy. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e746 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jorge Rioja Zaragoza, Spain More articles by this author Miguel Hurtado Caceres, Spain More articles by this author Federico Soria Caceres, Spain More articles by this author Angel Borque Zaragoza, Spain More articles by this author Luis Plaza Zaragoza, Spain More articles by this author Francisco Miguel Sanchez-Margallo Caceres, Spain More articles by this author Jesus Uson Caceres, Spain More articles by this author Luis Angel Rioja Zaragoza, Spain More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...