Laparoscopic nephrectomy in inflammatory renal disease: proposal for a staged approach
| Autor: | Eric Roger Wroclawski, Roberto Vaz Juliano, Marco T. Lasmar, Pedro Hermínio Forseto, Marcos Tobias-Machado, Lucas Teixeira Batista |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2005 |
| Předmět: |
Laparoscopic surgery
Adult medicine.medical_specialty kidney Urology medicine.medical_treatment laparoscopy Disease lcsh:RC870-923 Kidney Nephrectomy kidney calculi pyonephrosis nephrectomy Medicine Humans Prospective Studies Laparoscopy Peritoneal Cavity Aged medicine.diagnostic_test Pyelonephritis Hand assistance business.industry Laparoscopic nephrectomy Middle Aged lcsh:Diseases of the genitourinary system. Urology medicine.disease Surgery Review Literature as Topic medicine.anatomical_structure Treatment Outcome pyelonephritis Pyonephrosis business Tomography X-Ray Computed Follow-Up Studies |
| Zdroj: | International braz j urol v.31 n.1 2005 International Braz J Urol Sociedade Brasileira de Urologia (SBU) instacron:SBU International braz j urol, Volume: 31, Issue: 1, Pages: 22-28, Published: FEB 2005 International Brazilian Journal of Urology, Vol 31, Iss 1, Pp 22-28 (2005) |
| Popis: | Introduction: The present study shows and discusses the preliminary experience of custom-ized and staged approach in the minimally invasive treatment of inflammatory renal diseases, usingeither pure laparoscopic surgery or the hand-assisted technique.Materials and Methods: We prospectively assessed 17 patients with inflammatory renal dis-eases operated by laparoscopic approach. Mean age was 41 years and the surgical indication wasrepeated pyelonephritis in 8 cases, pyonephrosis in 4 cases and renal exclusion due to staghorn stonein 5 cases. The staged laparoscopic approach was chosen based on kidney size and on the presence ornot of tomographic findings showing significant perirenal infiltration. Thus, retroperitoneal accesswas chosen in cases where the kidney was smaller than 12 cm or in the absence of signs of significantperirenal infiltration on the computerized tomography. For the remainder, transperitoneal access wasemployed.Results: Of the 17 patients, 11 underwent laparoscopic nephrectomy by retroperitoneal ac-cess, and all cases were successful. Mean surgical time was 160 minutes. In 6 cases where the nephre-ctomy was performed by laparoscopic transperitoneal access, the use of hand assistance was required.Four surgeries were successfully completed with mean time of 190 minutes and 2 were converted toopen surgery with mean time of 220 minutes.Conclusion: The laparoscopic nephrectomy for inflammatory renal disease is feasible, butpresents a high degree of complexity, requiring a customized approach. The use of hand assistance isan attractive option when the inflammatory process is intense, and can avoid conversions, maintain-ing the advantages of minimally invasive treatments.Key words : kidney; laparoscopy; nephrectomy; pyelonephritis; pyonephrosis; kidney calculiInt Braz J Urol. 2005; 31: 22-28 |
| Databáze: | OpenAIRE |
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