Bilateral Laparoscopic Radical Nephrectomy for Renal Tumors in Patients with Acquired Cystic Kidney Disease
| Autor: | Roberto Pedraza, Truman A. Sasaki, S. Reza Ghasemian, Sunil V. Patel, Jimmy A. Light |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
Adult
Male medicine.medical_specialty media_common.quotation_subject Renal hilum Nephrectomy Cystic kidney disease Postoperative Complications Blood loss Recurrence medicine Carcinoma Humans In patient Carcinoma Renal Cell media_common Kidney business.industry Convalescence Kidney Diseases Cystic Length of Stay Middle Aged medicine.disease Kidney Neoplasms Surgery Treatment Outcome medicine.anatomical_structure Female Laparoscopy Laparoscopic radical nephrectomy business |
| Zdroj: | Journal of Laparoendoscopic & Advanced Surgical Techniques. 15:606-610 |
| ISSN: | 1557-9034 1092-6429 |
| DOI: | 10.1089/lap.2005.15.606 |
| Popis: | We describe our experience with simultaneous bilateral laparoscopic radical nephrectomy performed in patients with acquired cystic kidney disease (ACKD) and renal tumors.Between June 2000 and September 2002, 10 patients with ACKD underwent simultaneous bilateral laparoscopic radical nephrectomy for renal lesions suspicious for carcinoma. The lesions were discovered during pretransplant evaluation in 9 patients and incidentally in 1 renal transplant recipient. A 3- or 4-port transperitoneal approach was used for each side to mobilize the kidney and secure the renal hilum. Both specimens were extracted through a midline supraumbilical incision. Operative time, blood loss, analgesic requirements, hospital stay, and convalescence and recurrence rates were determined.The mean age of the patients was 41.6 years (range, 29-47 years). Mean operative time was 6.5 hours (range, 4.5-9.7 hours) and mean estimated blood loss was 164 cc (range, 50-300 cc). There was one intraoperative complication-a clotted arteriovenous (AV) graft; and 2 postoperative complications-1 fluid overload and 1 adrenal insufficiency. The average length of hospital stay was 3.1 days (range, 2-4 days) and mean convalescence was 2.8 weeks (range, 1-6 weeks). All cancers were confined to the kidneys and there has been no recurrence during follow-up ranging from 6 to 26 months.Bilateral laparoscopic radical nephrectomy in end-stage renal disease patients is safe and feasible. The advantages of the laparoscopic approach include minimal intraoperative blood loss, shorter hospital stay, minimal postoperative pain, and a rapid return to normal activity. The laparoscopic technique offers an effective, minimally invasive therapeutic alternative to open surgery in high-risk end-stage renal disease patients. |
| Databáze: | OpenAIRE |
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