| Autor: |
Hong Gee Sim, Sidney K.H. Yip, Chee Yong Ng, Yee Sze Teo, Yeh Hong Tan, Woei Yun Siow, Wai Sam Cheng |
| Jazyk: |
angličtina |
| Rok vydání: |
2005 |
| Předmět: |
|
| Zdroj: |
Asian Journal of Surgery, Vol 28, Iss 4, Pp 277-281 (2005) |
| Druh dokumentu: |
article |
| ISSN: |
1015-9584 |
| DOI: |
10.1016/S1015-9584(09)60360-2 |
| Popis: |
The pace of implementation of a laparoscopic nephrectomy programme is affected by factors including surgical expertise, case load, learning curves and outcome audits. We report our experience in introducing a laparoscopic nephrectomy programme over a 3-year period. Methods: From January 2001 to December 2003, 187 nephrectomies were performed (105 by conventional surgery, 82 by laparoscopy). Hand-assisted laparoscopy was used predominantly. The indications for surgery, factors affecting the approach and outcome parameters were studied. A cost comparison was made between patients with similar-sized renal tumours undergoing laparoscopic versus open surgery. Results: Most operations were performed for malignancy in both the open (70%) and laparoscopic (67%) surgery groups. The laparoscopic approach was most commonly used in upper tract transitional cell cancers (TCCs; 70% of 30 patients) and benign pathologies (49% of 35 patients), followed by radical nephrectomies (34% of 99 patients) and donor nephrectomies (44% of 23 patients). There was a rapid rise in laparoscopic surgeries, from 30% in 2001 to 58% in 2002. The median hospital stay was 5.8 days in the laparoscopic group and 8.1 days in the open surgery group. The procedure cost for laparoscopic surgery was S$4,943 compared with S$4,479 for open surgery. However, due to a shorter hospital stay, the total hospital cost was slightly lower in the laparoscopic group (S$7,500 versus S$7,907). Conclusion: The laparoscopic approach for various renal pathologies was quickly established with a rapid increase in the number of laparoscopic procedures. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
|
