Abstract
BackgroundTo explore the feasibility and safety of retroperitoneal laparoscopic partial nephrectomy with sequential segmental renal artery clamping for the patients with multiple renal tumor of who have solitary kidney or contralateral kidney insufficiency.MethodsNine patients who have undergone retroperitoneal laparoscopic partial nephrectomy with sequential segmental renal artery clamping between October 2010 and January 2017 were retrospectively analyzed. Clinical materials and parameters during and after the operation were summarized.ResultsNineteen tumors were resected in nine patients and the operations were all successful. The operation time ranged from 100 to 180 min (125 min); clamping time of segmental renal artery was 10 ~ 30 min (23 min); the amount of blood loss during the operation was 120 ~ 330 ml (190 ml); hospital stay after the operation is 3 ~ 6d (5d). There was no complication during the perioperative period, and the pathology diagnosis after the surgery showed that there were 13 renal clear cell carcinomas, two papillary carcinoma and four perivascular epithelioid cell tumors with negative margins from the 19 tumors. All patients were followed up for 3 ~ 60 months, and no local recurrence or metastasis was detected. At 3-month post-operation follow-up, the mean serum creatinine was 148.6 ± 28.1 μmol/L (p = 0.107), an increase of 3.0 μmol/L from preoperative baseline.ConclusionsFor the patients with multiple renal tumors and solitary kidney or contralateral kidney insufficiency, retroperitoneal laparoscopic partial nephrectomy with sequential segmental renal artery clamping was feasible and safe, which minimized the warm ischemia injury to the kidney and preserved the renal function effectively.
Highlights
To explore the feasibility and safety of retroperitoneal laparoscopic partial nephrectomy with sequential segmental renal artery clamping for the patients with multiple renal tumor of who have solitary kidney or contralateral kidney insufficiency
Surgeons conduct the tumor excision and wound suture in the state of complete renal ischemia with main renal artery clamped,which is usually complete within 20 ~ 30 min to avoid the kidney from irreversible injury [6]
We retrospectively analyzed the clinical data of 9 patients from October 2010 to January 2017 who underwent retroperitoneal laparoscopic partial nephrectomy with sequential segmental renal artery clamping which avoided the complete renal ischemia during the whole surgical process
Summary
To explore the feasibility and safety of retroperitoneal laparoscopic partial nephrectomy with sequential segmental renal artery clamping for the patients with multiple renal tumor of who have solitary kidney or contralateral kidney insufficiency. In regard to some patients with solitary kidney or contralateral kidney insufficiency, partial nephrectomy can effectively reduce the incidence of dialysis on account of postoperative kidney failure [5]. Surgeons conduct the tumor excision and wound suture in the state of complete renal ischemia with main renal artery clamped,which is usually complete within 20 ~ 30 min to avoid the kidney from irreversible injury [6]. We retrospectively analyzed the clinical data of 9 patients from October 2010 to January 2017 who underwent retroperitoneal laparoscopic partial nephrectomy with sequential segmental renal artery clamping which avoided the complete renal ischemia during the whole surgical process.
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