The value of superior retroperitoneal fold ligament in retroperitoneal laparoscopic radical nephrectomy

Abstract

Objective To investigate the clinical feasibility and value of the superior retroperitoneal fold ligament as the marker to enter anterior pararenal space and remove prerenal fascia as the first step for retroperitoneal laparoscopic radical nephrectomy. Methods The clinical data of 60 patients (male:n=38, female:n=22, average age=46 years, the diameter of tumor=3.8-8.4 cm, average=5.6 cm) who underwent retroperitoneal laparoscopic radical nephrectomy from March 2016 to March 2018 were retrospectively analyzed. The first step of the operation used the superior retroperitoneal fold ligament as the marker to enter anterior pararenal space in order to remove prerenal fascia with the kidney. Results All the operations were performed successfully by removing prerenal fascia with the kidney. The average operation time was 55 min, the average blood loss was 30 ml, the had been average ambulation time was 15 hours, the average postoperative hospital stay was 6 days. 56 cases had been followed up for 9(6-24) months, no local recurrence of tumor was found. Conclusions Using superior retroperitoneal fold ligament as the marker in the first step of retroperitoneal laparoscopic radical nephrectomy can efficiently identify the border between retroperitoneal fold and lateral conal fascia, which will make it easier to enter anterior pararenal space and remove prerenal fascia for meeting the standards of radical nephrectomy. It is worth popularizing in clinical practice. Key words: Superior retroperitoneal fold ligament; Retroperitoneal laparoscopy; Radical nephrectomy; Anterior pararenal space; Prerenal fascia