Retroperitoneal laparoscopic partial nephrectomy for renal tumors

Abstract

Objective To explore the clinical value and efficacy of retroperitoneal laparoscopicpartial nephrectomy. Methods From July 2013 to November 2017, 37 patients with renal tumors were received retroperitoneal laparoscopic partial nephrectomy in our hospital, the lesions demonstrated in renal clear cell carcinoma(23 lesions in T1a stage, 4 lesions in T1b stage), hamartoma(9 lesions), chromophobe carcinoma(1 lesion in T1a stage). Retroperitoneal space conventional was prepared, the Gerota fascia was opened, the renal artery trunk was found, arteries with bull-dog clamp were blocked, mass and the normal tissue which was 0.5 cm away from the tumor margin were resected and wound surface with Hem-o-lock fixed was sutured. Results Laparoscopic partial nephrectomy(LPN) was performed successfully in 36 cases, 1 case transited to open surgery due to the notcompletely blocked renal artery, 2 cases did not have renal artery blocked.Statistically, the average operation time was 95 min (65-225 min) and blood loss was 125 mL(20-1000 mL), clamping time 24 min (10-35 min)during the operation.One case had postoperation secondary bleeding and took selective renal artery embolization.The mean hospital stage was 14.6 days(11-27 days) .These cases were followed up for 3 to 27 months, none of them had long-term complications and recurrency. Conclusions Retroperitoneal laparoscopic partial nephrectomy has several advantages of safety, efficiency, minimally invasion and rapid recovery, which should be promoted. Key words: Kidney Neoplasms; Laparoscopes; Nephrectomy