Skip to main content
Top
Published in: World Journal of Surgical Oncology 1/2013

Open Access 01-12-2013 | Research

Fast access and early ligation of the renal pedicle significantly facilitates retroperitoneal laparoscopic radical nephrectomy procedures: modified laparoscopic radical nephrectomy

Authors: Qing Yang, Jun Du, Zhi-Hua Zhao, Xu-Sheng Chen, Lei Zhou, Xin Yao

Published in: World Journal of Surgical Oncology | Issue 1/2013

Login to get access

Abstract

Background

The objective of this study was to develop a modified retroperitoneal laparoscopic nephrectomy and compare its results with the previous technique.

Methods

One hundred retroperitoneal laparoscopic nephrectomies were performed from February 2007 to October 2011. The previous technique was performed in 60 cases (Group 1). The modified technique (n = 40) included fast access to the renal pedicle according to several anatomic landmarks and early ligation of renal vessels (Group 2). The mean operation time, mean blood loss, duration of hospital stay conversion rate and complication rate were compared between the groups.

Results

No significant differences were detected regarding mean patient age, mean body mass index, and tumor size between the two groups (P >0.05). The mean operation time was 59.5 ± 20.0 and 39.5 ± 17.5 minutes, respectively, in Groups 1 and 2 (P <0.001). The mean intraoperative blood loss was 147 ± 35 and 100 ± 25 ml, respectively, in Groups 1 and 2 (P <0.001). No significant differences were detected regarding the conversion rate and the complication rate between the two groups (P >0.05).

Conclusions

Early ligature using fast access to the renal vessels during retroperitoneal laparoscopic radical nephrectomy contributed to less operation time and intraoperative blood loss compared with the previous technique. In addition, the modified technique permits the procedure to be performed following the principles of open radical nephrectomy.
Appendix
Available only for authorised users
Literature
1.
go back to reference Dunn MD, Portis AJ, Shalhav AL, Elbahnasy AM, Heidorn C, McDougall EM, Clayman RV: Laparoscopic versus open radical nephrectomy: a 9-year experience. J Urol. 2000, 164: 1153-1159. 10.1016/S0022-5347(05)67131-5.CrossRefPubMed Dunn MD, Portis AJ, Shalhav AL, Elbahnasy AM, Heidorn C, McDougall EM, Clayman RV: Laparoscopic versus open radical nephrectomy: a 9-year experience. J Urol. 2000, 164: 1153-1159. 10.1016/S0022-5347(05)67131-5.CrossRefPubMed
2.
go back to reference McDougall E, Clayman RV, Elashry OM: Laparoscopic radical nephrectomy for renal tumor: the Washington University experience. J Urol. 1996, 155: 1180-1185. 10.1016/S0022-5347(01)66207-4.CrossRefPubMed McDougall E, Clayman RV, Elashry OM: Laparoscopic radical nephrectomy for renal tumor: the Washington University experience. J Urol. 1996, 155: 1180-1185. 10.1016/S0022-5347(01)66207-4.CrossRefPubMed
3.
4.
go back to reference Ono Y, Kinukawa T, Hattori R, Gotoh M, Kamihira O, Ohshima S: The long-term outcome of laparoscopic radical nephrectomy for small renal cell carcinoma. J Urol. 2001, 165: 1867-1870. 10.1016/S0022-5347(05)66230-1.CrossRefPubMed Ono Y, Kinukawa T, Hattori R, Gotoh M, Kamihira O, Ohshima S: The long-term outcome of laparoscopic radical nephrectomy for small renal cell carcinoma. J Urol. 2001, 165: 1867-1870. 10.1016/S0022-5347(05)66230-1.CrossRefPubMed
5.
go back to reference Gill IS: Laparoscopic radical nephrectomy for cancer. Urol Clin North Am. 2000, 27: 707-719. 10.1016/S0094-0143(05)70120-8.CrossRefPubMed Gill IS: Laparoscopic radical nephrectomy for cancer. Urol Clin North Am. 2000, 27: 707-719. 10.1016/S0094-0143(05)70120-8.CrossRefPubMed
6.
go back to reference Robson CJ: Radical nephrectomy for renal cell carcinoma. J Urol. 1963, 89: 37-42.PubMed Robson CJ: Radical nephrectomy for renal cell carcinoma. J Urol. 1963, 89: 37-42.PubMed
7.
go back to reference Wille AH, Roigas J, Deger S, Tullmann M, Turk I, Loening SA: Laparoscopic radical nephrectomy: techniques, results and oncological outcome in 125 consecutive cases. Eur Urol. 2004, 45: 483-488. 10.1016/j.eururo.2003.10.019. discussion 488–489CrossRefPubMed Wille AH, Roigas J, Deger S, Tullmann M, Turk I, Loening SA: Laparoscopic radical nephrectomy: techniques, results and oncological outcome in 125 consecutive cases. Eur Urol. 2004, 45: 483-488. 10.1016/j.eururo.2003.10.019. discussion 488–489CrossRefPubMed
8.
go back to reference Rassweiler JJ, Schulze M, Marrero R, Frede T, Palou Redorta J, Bassi P: Laparoscopic nephroureterectomy for upper urinary tract transitional cell carcinoma: is it better than open surgery?. Eur Urol. 2004, 46: 690-697. 10.1016/j.eururo.2004.08.006.CrossRefPubMed Rassweiler JJ, Schulze M, Marrero R, Frede T, Palou Redorta J, Bassi P: Laparoscopic nephroureterectomy for upper urinary tract transitional cell carcinoma: is it better than open surgery?. Eur Urol. 2004, 46: 690-697. 10.1016/j.eururo.2004.08.006.CrossRefPubMed
9.
go back to reference Robson CJ, Churchill BM, Anderson W: The results of radical nephrectomy for renal cell carcinoma. Trans Am Assoc Genitourin Surg. 1968, 60: 122-129.PubMed Robson CJ, Churchill BM, Anderson W: The results of radical nephrectomy for renal cell carcinoma. Trans Am Assoc Genitourin Surg. 1968, 60: 122-129.PubMed
10.
go back to reference Robson CJ, Churchill BM, Anderson W: The results of radical nephrectomy for renal cell carcinoma. J Urol. 1969, 101: 297-301.PubMed Robson CJ, Churchill BM, Anderson W: The results of radical nephrectomy for renal cell carcinoma. J Urol. 1969, 101: 297-301.PubMed
11.
go back to reference Clayman RV, Kavoussi LR, Soper NJ, Dierks SM, Meretyk S, Darcy MD, Roemer FD, Pingleton ED, Thomson PG, Long SR: Laparoscopic nephrectomy: initial case report. J Urol. 1991, 146: 278-282.PubMed Clayman RV, Kavoussi LR, Soper NJ, Dierks SM, Meretyk S, Darcy MD, Roemer FD, Pingleton ED, Thomson PG, Long SR: Laparoscopic nephrectomy: initial case report. J Urol. 1991, 146: 278-282.PubMed
12.
go back to reference Permpongkosol S, Chan DY, Link RE, Jarrett TW, Kavoussi LR: Laparoscopic radical nephrectomy: long-term outcomes. J Endourol. 2005, 19: 628-633. 10.1089/end.2005.19.628.CrossRefPubMed Permpongkosol S, Chan DY, Link RE, Jarrett TW, Kavoussi LR: Laparoscopic radical nephrectomy: long-term outcomes. J Endourol. 2005, 19: 628-633. 10.1089/end.2005.19.628.CrossRefPubMed
13.
go back to reference Gill IS, Schweizer D, Hobart MG, Sung GT, Klein EA, Novick AC: Retroperitoneal laparoscopic radical nephrectomy: the Cleveland clinic experience. J Urol. 2000, 163: 1665-1670. 10.1016/S0022-5347(05)67516-7.CrossRefPubMed Gill IS, Schweizer D, Hobart MG, Sung GT, Klein EA, Novick AC: Retroperitoneal laparoscopic radical nephrectomy: the Cleveland clinic experience. J Urol. 2000, 163: 1665-1670. 10.1016/S0022-5347(05)67516-7.CrossRefPubMed
14.
go back to reference Gao J, Guo G, Jie Z, Wei W, Xu A, Dong J, Hong B: A fast method to identify renal vessels during retroperitoneal laparoscopic nephrectomy. J Endourol. 2008, 22: 1705-1708. 10.1089/end.2008.0028.CrossRefPubMed Gao J, Guo G, Jie Z, Wei W, Xu A, Dong J, Hong B: A fast method to identify renal vessels during retroperitoneal laparoscopic nephrectomy. J Endourol. 2008, 22: 1705-1708. 10.1089/end.2008.0028.CrossRefPubMed
15.
go back to reference Porpiglia F, Terrone C, Cracco C, Renard J, Musso F, Grande S, Scarpa RM: Direct access to the renal artery at the level of treitz ligament during left radical laparoscopic transperitoneal nephrectomy. Eur Urol. 2005, 48: 291-295. 10.1016/j.eururo.2005.03.024.CrossRefPubMed Porpiglia F, Terrone C, Cracco C, Renard J, Musso F, Grande S, Scarpa RM: Direct access to the renal artery at the level of treitz ligament during left radical laparoscopic transperitoneal nephrectomy. Eur Urol. 2005, 48: 291-295. 10.1016/j.eururo.2005.03.024.CrossRefPubMed
16.
go back to reference Porpiglia F, Terrone C, Cracco C, Cossu M, Grande S, Musso F, Renard J, Scarpa RM: Early ligature of renal artery during radical laparoscopic transperitoneal nephrectomy: description of standard technique and direct access. J Endourol. 2005, 19: 623-626. 10.1089/end.2005.19.623. discussion 626–627CrossRefPubMed Porpiglia F, Terrone C, Cracco C, Cossu M, Grande S, Musso F, Renard J, Scarpa RM: Early ligature of renal artery during radical laparoscopic transperitoneal nephrectomy: description of standard technique and direct access. J Endourol. 2005, 19: 623-626. 10.1089/end.2005.19.623. discussion 626–627CrossRefPubMed
17.
go back to reference Porpiglia F, Renard J, Billia M, Morra I, Scoffone C, Cracco C, Tarabuzzi R, Terrone C, Scarpa RM: Left laparoscopic radical nephrectomy with direct access to the renal artery: technical advantages. Eur Urol. 2006, 49: 1004-1010. 10.1016/j.eururo.2006.02.038.CrossRefPubMed Porpiglia F, Renard J, Billia M, Morra I, Scoffone C, Cracco C, Tarabuzzi R, Terrone C, Scarpa RM: Left laparoscopic radical nephrectomy with direct access to the renal artery: technical advantages. Eur Urol. 2006, 49: 1004-1010. 10.1016/j.eururo.2006.02.038.CrossRefPubMed
18.
go back to reference Tunc L, Canda AE, Polat F, Onaran M, Atkin S, Biri H, Bozkirli I: Direct upper kidney pole access and early ligation of renal pedicle significantly facilitates transperitoneal laparoscopic nephrectomy procedures: Tunc technique. Surg Laparosc Endosc Percutan Tech. 2011, 21: 453-457. 10.1097/SLE.0b013e31823badc1.CrossRefPubMed Tunc L, Canda AE, Polat F, Onaran M, Atkin S, Biri H, Bozkirli I: Direct upper kidney pole access and early ligation of renal pedicle significantly facilitates transperitoneal laparoscopic nephrectomy procedures: Tunc technique. Surg Laparosc Endosc Percutan Tech. 2011, 21: 453-457. 10.1097/SLE.0b013e31823badc1.CrossRefPubMed
19.
go back to reference Dunn MD, Shalhav AL, McDougall EM, Clayman RV: Laparoscopic nephrectomy and nephroureterectomy for renal and upper tract transitional cell cancer. Semin Laparosc Surg. 2000, 7: 200-210. 10.1053/slas.2000.5596.CrossRefPubMed Dunn MD, Shalhav AL, McDougall EM, Clayman RV: Laparoscopic nephrectomy and nephroureterectomy for renal and upper tract transitional cell cancer. Semin Laparosc Surg. 2000, 7: 200-210. 10.1053/slas.2000.5596.CrossRefPubMed
Metadata
Title
Fast access and early ligation of the renal pedicle significantly facilitates retroperitoneal laparoscopic radical nephrectomy procedures: modified laparoscopic radical nephrectomy
Authors
Qing Yang
Jun Du
Zhi-Hua Zhao
Xu-Sheng Chen
Lei Zhou
Xin Yao
Publication date
01-12-2013
Publisher
BioMed Central
Published in
World Journal of Surgical Oncology / Issue 1/2013
Electronic ISSN: 1477-7819
DOI
https://doi.org/10.1186/1477-7819-11-27

Other articles of this Issue 1/2013

World Journal of Surgical Oncology 1/2013 Go to the issue