Análise retrospectiva dos primeiros 100 casos de cirurgias por retroperitoneoscopia do Centro Hospitalar do Tâmega e Sousa

Abstract

IntroductionSince the introduction of minimal invasive surgery in the 90s, many international urologic centres have developed retroperitoneoscopy as access way for treatment of multiple urologic pathologies. ObjectivesThe aim of this work is to analyze our initial experience in retroperitoneoscopy. Materials and methods: Retrospective analysis of the first 100 cases of retroperitoneoscopy by counsulting the clinical records. These operations were classified according to their technical difficulty and operative risk. Operative complications were stratified into five grades using the modified Clavien classification system (CCS). ResultsThe first 100 retroperitoneoscopic procedures of our hospital were performed from January 2008 to July 2013 in 51 men and 49 women with a mean age of 52 years old (18‐84 years old).They were comprised of 22 renal cyst marsupialization, 36 Simple Nephrectomies, 4 Radical Nephrectomies, 2 Nephroureterectomies, 14 dismembered pyeloplasties, 1 lumbar ureterolithotomy and 21 Parcial Nephrectomies.Using the classification of surgical complexity European Scoring System for Laparoscopic Operations in Urology modified by Rassweiler in 2006, we classified 22 procedures as simple, 57 procedures as difficult and 21 procedures as very difficult. The mean operation time was 158minutes (range: 67‐280minutes). The mean operation time was 96, 157, and 220minutes in simple, difficult and very difficult procedures, repectively.The open conversion rate was 3%. A total of 12 patients had postoperative complications: CCS Grade I in 4, CCS Grade II in 6 and CCS Grade IIIb in 2 patients. Discussion/Conclusions: The retroperitoneoscopy has proven to be a safe and a versatile access for a minimally invasive treatment of many urologic pathologies.