The efficiency of using dual laser system zero in off clamp nephron-sparing surgery

Abstract

Objective To evaluate the efficacy of using dual laser system in off clamp nephron-sparing surgery. Methods We used dual laser system in the patients who underwent off-clamp NSS between Jan 2016 and Apr 2016 in our institution. There were 16 males and 8 females with average age of 49 years. Mean tumor size was 1.9 cm (range 0.8-3.2 cm). The mean R. E.N.A.L. score was 3.8(range 3-6). The mean Zhongshan score was 3.5(range 3-5). The mean ZII(zero ischemia index)was 1.6(range 1-4). The Evolve Dual (980 nm/1 470 nm) laser system set at 60 W in continuous mode was used. Results Off-clamp NSS was successfully performed in 22 patients except for renal artery occlusion in 2 case. Mean operative time was 74 min(range 50-100 min); The average estimated blood loss was 52.9 ml(range 10-200 ml); Mean postoperative drainage was 65.4 ml(range 20-150ml); Mean postoperative hospital stay was 5.2 days (range: 4-7days). No severe post-operative complication was found. The mean pre- and postoperative serum creatinine levels were 76.2 μmol/L(range: 48-112μmol/L) and 81.5μmol/L(range: 54-122 μmol/L) with no significant difference(P>0.05). The postoperative pathology indicated that 20 cases of clear cell carcinomas, 3 cases of chromophobe renal cell carcinomas, one case of papillary carcinoma. Conclusions Dual laser system can be used in off clamp nephron-sparing surgery safely and effectively. Key words: Nephron sparing surgery; Off-clamp; Renal neoplasm; Dual laser system