Retroperitoneal laparoscopic radical nephrectomy: technical improvements and complication prevention
10.3760/cma.j.issn.1000-6702.2009.05.003
- VernacularTitle:后腹腔镜下根治性肾切除术技术改进与并发症防治
- Author:
Hailiang ZHANG
;
Dingwei YE
;
Xudong YAO
;
Shilin ZHANG
;
Bo DAI
;
Yijun SHEN
;
Yao ZHU
;
Yiping ZHU
;
Guohai SHI
;
Chunguang MA
- Publication Type:Journal Article
- Keywords:
Kidney neoplasms;
Nephrectomy;
Laparoscopes;
Complication
- From:
Chinese Journal of Urology
2009;30(5):302-305
- CountryChina
- Language:Chinese
-
Abstract:
Objective To introduce the technical improvements in retroperitoneal laparoscopic radical nephrectomy and discuss their roles in decreasing the perioperative complication. Methods Sixty-one patients with localized renal cell carcinoma were treated with retroperitoneal laparoscopic radical nephrectomy from December 2006 to March 2008. Pre-operative CT scan was performed to evaluate the renal vessel status. Thirty degree laparoscope was used together with self-made balloon dilator to establish the retroperitoneal space. Harmonic scalpel was used in dissection and removal of the extra-peritoneal fat. Cautions were taken during the separation of peritoneum. The renal artery and vein were separated and ligated with Hem-o-lok clips. Complications such as vessel split and intes-tinal injury were recorded. Operation time, estimated blood loss, drainage volume, and length of hos-pital stay were analyzed as well. Results The operation time was 50-135 min, estimated blood loss during operation was 20-170 ml, post-operative drainage volume was 20-210 ml, mean post-opera-tive length of hospital stay was 5 d. Two complications occurred during the operation: one was a vena eava injury, and another was a minor duodenum wall perforation. Conclusions Retroperitoneal lapa-roscopic radical nephrectomy is an effective and safe surgical option for localized renal cell carcinoma. Improvements in this surgical technique bring more safety and convenience and could decrease perio-perative complications relatively.
