Laparoscopic Partial Nephrectomy with Diode Laser: A Promising Technique
| Autor: | Zeljko Kastelan, Marija Topalović Grković, Nikola Knezevic, Tomislav Kuliš, Marjan Maric, Ivan Krhen |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Urinary system Single tumor Biomedical Engineering RENAL-CELL CARCINOMA EAU GUIDELINES YAG LASER COMPLICATIONS SURGERY CANCER Nephrectomy Tumor excision medicine Humans Radiology Nuclear Medicine and imaging Warm Ischemia Laparoscopy Carcinoma Renal Cell Original Research Aged medicine.diagnostic_test Warm Ischemia Time business.industry Minimum distance Middle Aged Kidney Neoplasms Surgery Operative time Female Laser Therapy business Tomography X-Ray Computed |
| Popis: | OBJECTIVE: The aim of this study was to evaluate application of diode laser in laparoscopic partial nephrectomy (LPN), and to question this technique in terms of ease of tumor excision and reduction of warm ischemia time (WIT). ----- BACKGROUND DATA: LPN is the standard operative method for small renal masses. The benefits of LPN are numerous, including preserving renal function and prolonging overall survival. However, reduction of WIT remains main challenge in this operation. In order to shorten WIT, many techniques have been developed, with variable results. ----- PATIENTS AND METHODS: We performed a prospective collection and analysis of health records for patients who were operated on between March 2011 and August 2012. Inclusion criteria were single tumor ≤ 4 cm, predominant exophytic growth and intraparenchymal depth ≤ 1.5 cm, with a minimum distance of 5 mm from the urinary collecting system. ----- RESULTS: We operated on 17 patients. Median operative time was 170 min. In all but two patients, we had to perform hilar clamping. Median duration of WIT was 16 min. Pathohistological evaluation revealed clear cell renal cancer and confirmed margins negative for tumor in all cases. Median size of the tumor was 3 cm. Median postoperative hospitalization was 5 days. Average follow up was 11.5 months. There were no intraoperative complications. One postoperative complication was noted: perirenal hematoma. ----- CONCLUSIONS: Laser LPN is feasible, and offers the benefit of shorter WIT, with effective tissue coagulation and hemostasis. With operative experience and technical advances, WIT will be reduced or even eliminated, and a solution to some technical difficulties, such as significant smoke production, will be found. |
| Databáze: | OpenAIRE |
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