Fast access and early ligation of the renal pedicle si...

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.天津医科大学肿瘤医院泌尿肿瘤科杜君

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.