Clinical value of laparuscopic ultrasonography in nephron sparing surgery for central renal tumors

Abstract

Objective To discuss the clinical application of laparoscopic ultrasound (LUS) in laparoscopic nephron sparing surgery(NSS) for central renal tumors.Methods Eighteen patients underwent laparoscopic NSS for central renal tumors.The use of LUS was mainly lay in observing the nature and size of the tumor, the minimum distance from the tumor to capsule, collective system and renal artery, tumor's vasa vasorum,tumor localization and determination of margins.Results Of the 18 central renal tumors,the size was 11 - 29 mm,23.3 mm in average.The minimum distance from the tumor to capsule was 2 - 11mm,4.7 mm in average.The minimum distance within 5 mm to collective system and to capsule was 12 and 10 cases respectively.The tumor was surrounded by nephridial tissue completely on LUS, without protruding capsule.LUS diagnosis of 18 central renal tumors: 10 cases of renal angiomyolipoma,7 cases of renal cell carcinoma, 1 case of renal cyst with capsule wall calcification (at first diagnosed as renal carcinoma by CT).The findings of LUS were same to pathologic and(or) postoperative diagnoses.The accuracy of ultrasound localization was 100％.The surgical margins of 7 cases of renal cell carcinoma were all negative.Conclusions It is of high clinical value of LUS on locating the tumor and defining tumor margins in laparoscopic resection of central renal tumors.Besides, more information on tumor and vessel supply will be achieved. Key words: Endosonography; Kidney neoplasms; Laparoscopy