Partial nephrectomy with retroperitoneal laparoscopy

被引:89
作者
Hoznek, A [1 ]
Salomon, L
Antiphon, P
Radier, C
Hafiani, M
Chopin, DK
Abbou, CC
机构
[1] CHU Henri Mondor, Serv Urol, F-94010 Creteil, France
[2] CHU Henri Mondor, Serv Radiol & Imagerie Med, F-94010 Creteil, France
关键词
laparoscopy; kidney neoplasms; urogenital abnormalities; tissue adhesives; hemostasis;
D O I
10.1016/S0022-5347(05)68069-X
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Purpose: Laparoscopy has gradually gained acceptance for a variety of ablative procedures of the retroperitoneal organs, and the indications are being extended to more complex reconstructive and organ preserving procedures. We report our experience with retroperitoneal laparoscopic partial nephrectomy. Materials and Methods: Retroperitoneal laparoscopic partial nephrectomy was performed for benign conditions in 6, equivocal solid masses in 4 and indeterminate cysts in 3 patients. If malignancy was suspected, laparoscopic sonography was used to assess the intrarenal anatomy and the mass. To facilitate parenchymal closure during nephron sparing surgery we used a hemostatic biological glue that consisted of gelatin, resorcinol and formaldehyde. Results: Average operating time was 113 minutes and average blood loss was 72 ml. Histological examination revealed malignancy in 1 of the 3 cystic lesions and 2 of the 4 equivocal solid masses. There were 2 postoperative urinomas. Conclusions: Partial nephrectomy with retroperitoneal laparoscopy is feasible, and has a reasonable operating time and blood loss. Laparoscopic ultrasound was an important decision making aid during surgery. The use of biological glue-simplified hemostasis and closure of the collecting system but good quality drainage of the collecting system is still required to decrease the risk of urinoma. The development of surgical tools that allow bloodless and nontraumatic section of the renal parenchynza is required to facilitate laparoscopic nephron sparing surgery. The ultrasonic scalpel needs further evaluation in this setting.
引用
收藏
页码:1922 / 1926
页数:5
相关论文
共 20 条
[1]  
AUVERT J, 1975, NOUV PRESSE MED, V4, P733
[2]  
Bachet J, 1997, J CARDIAC SURG, V12, P243
[3]   LAPAROSCOPIC EVALUATION OF INDETERMINATE RENAL CYSTS [J].
BELLMAN, GC ;
YAMAGUCHI, R ;
KASWICK, J .
UROLOGY, 1995, 45 (06) :1066-1070
[4]   MANAGEMENT OF SMALL UNILATERAL RENAL-CELL CARCINOMAS - RADICAL VERSUS NEPHRON-SPARING SURGERY [J].
BUTLER, BP ;
NOVICK, AC ;
MILLER, DP ;
CAMPBELL, SA ;
LICHT, MR .
UROLOGY, 1995, 45 (01) :34-40
[5]   CONSERVATIVE TREATMENT OF RENAL-ALLOGRAFT RUPTURE WITH POLYGLACTIN 910 MESH AND GELATIN RESORCIN FORMALDEHYDE GLUE [J].
CHOPIN, DK ;
ABBOU, CC ;
LOTTMANN, HB ;
POPOV, Z ;
LANG, PR ;
BUISSON, CL ;
BELGHITI, D ;
COLOMBEL, M ;
AUVERT, JM .
JOURNAL OF UROLOGY, 1989, 142 (02) :363-365
[6]   Assessment of alternative tissue approximation techniques for laparoscopy [J].
Eden, CG ;
Coptcoat, MJ .
BRITISH JOURNAL OF UROLOGY, 1996, 78 (02) :234-242
[7]   LAPAROSCOPIC RENAL SURGERY IN CHILDREN [J].
EHRLICH, RM ;
GERSHMAN, A ;
FUCHS, G .
JOURNAL OF UROLOGY, 1994, 151 (03) :735-739
[8]   Recent advances in laparoscopic partial nephrectomy: Comparative study of electrosurgical snare electrode and ultrasound dissection [J].
Elashry, OM ;
Wolf, JS ;
Rayala, HJ ;
McDougall, EM ;
Clayman, RV .
JOURNAL OF ENDOUROLOGY, 1997, 11 (01) :15-22
[9]   LAPAROSCOPIC RETROPERITONEAL PARTIAL NEPHRECTOMY [J].
GILL, IS ;
DELWORTH, MG ;
MUNCH, LC .
JOURNAL OF UROLOGY, 1994, 152 (05) :1539-1542
[10]   Laparoscopic nephron sparing surgery for small renal cell carcinoma [J].
Janetschek, G ;
Daffner, P ;
Peschel, R ;
Bartsch, G .
JOURNAL OF UROLOGY, 1998, 159 (04) :1152-1155