LAPAROSCOPIC TRANSPERITONEAL PARTIAL NEPHRECTOMY FOR A TUMOR OF THE UPPER SEGMENT
- Authors: Guliev B.G1, Yagubov K.K.1
-
Affiliations:
- I.I. Mechnikov North-Western State Medical University
- Issue: No 6 (2017)
- Pages: 96-100
- Section: Articles
- URL: https://journals.eco-vector.com/1728-2985/article/view/322124
- DOI: https://doi.org/10.18565/urology.2017.6.96-100
- ID: 322124
Cite item
Open Access
Access granted
Abstract
Introduction. Laparoscopic resection of upper pole kidney tumors is a technically challenging procedure. When tumors are located on the dorsal side of the kidney, the renal-rotation technique may facilitate laparoscopic partial nephrectomy. Aim. To present the technique and results of laparoscopic partial nephrectomy (LPN) for tumors of the upper pole of the kidney with its rotation around the renal hilum. Material and methods. The study presents a retrospective analysis of the results of 12 patients who underwent LPN for upper pole kidney tumors using the renal-rotation technique. The kidney with the renal hilar vessels and the upper third of the ureter were mobilized using a transperitoneal access. Then the kidney was rotated over its pedicular axis so that the upper pole was located inferiorly. As a result, the posterior upper pole tumor was located anteriorly, thereby facilitating its resection. After removing the tumor and confirming homeostasis, the kidney was returned to its original position. Results. The results of LPN using this technique were successful in all 12 patients. The mean operative time was 120±35.0 (90-210) min, the warm ischemia time was 14.5±7.8 (10-26) min, and the blood loss was 120.0±65.5 (60-300) ml. The intraoperative complication occurred in 1 (8.3%) patients, postoperative complications were observed in 3 patients. Histopathology showed that 11 (91.7%) patients had renal cell carcinoma and one (8.3%) had angiomyolipoma. Analysis of early (18.6±5.0 months) oncological outcomes showed no local recurrence and distant metastases. Conclusion. With dorsally located upper pole kidney tumors, the renalrotation technique facilitates the performance of LPN and minimizes the risk of intra- and postoperative complications. This method requires the maximum mobilization of the kidney along with the renal hilar vessels and the upper third of the ureter to rotate it for optimal resection conditions.
Keywords
Full Text
About the authors
B. G Guliev
I.I. Mechnikov North-Western State Medical University
Email: gulievbg@mail.ru
Dr.Med.Sci., Prof. at the Department of Urology St. Petersburg, Russia
Kh. Kh Yagubov
I.I. Mechnikov North-Western State Medical University
Email: khayyam2206@mail.ru
Ph.D. Student at the Department of Urology St. Petersburg, Russia
References
- Alyaev Yu.G., Krapivin A.A. The choice of diagnostic and therapeutic strategy for a kidney tumor. M., Triada. 2005. 221 p.
- Matveev V.B., Alekseev B.Ya. Laparoscopic surgery in oncology. M., 2007. 214 p.
- Van Poppel H., Becker F., Cadeddu J.A. et al. Treatment of localized renal cell carcinoma. Eur. Urol. 2011;60:662-672.
- Ljungberg B., Cowan N., Hanbury D.C. EAU guidelines on renal cell carcinoma: The 2010 update. Eur. Urol. 2010; 58: 398-406.
- Lane B.R., Gill I.S. 7-Year oncological outcomes after laparoscopic and open partial nephrectomy. J Urol. 2010;183: 473-479.
- Gill I.S., Kavoussi L.R., Lane B.R., Blute M.L., Babineau D., Colombo J.R. Jr, Frank I., Permpongkosol S., Weight C.J., Kaouk J.H., Kattan M.W., Novick A.C. Comparison of 1,800 laparoscopic
- Gong E.M., Orvieto M.A., Zorn K.C., Lucioni A., Steinberg G.D., Shalhav A.L. Comparison of laparoscopic and open partial nephrectomy in clinical T1a renal tumors. J Endourol. 2008;22:953-957.
- Richstone L., Montag S., Ost M., Reggio E., Permpongkosol S., Kavoussi L.R. Laparoscopic partial nephrectomy for hilar tumors: Evaluation of short-term oncologic outcome. Urology 2008;71: 36-40.
- Arvin K.G., Amin S.H., Soroush R.B. Laparoscopic partial nephrectomy for hilar tumors: Oncologic and renal functional outcomes. Urology 2014;83:111 - 115.
- Nadu A., Kleinmann N., Laufer M., Dotan Z., Winkler H., Ramon J. Laparoscopic partial nephrectomy for central tumors: Analysis of perioperative outcomes and complications. J Urol. 2009;181:42-47.
- Lattouf J.-B., Beri A., D’Ambros O.F., Grull M., Leeb K., Janetschek G. Laparoscopic partial nephrectomy for hilar tumors: Technique and results. Eur. Urol. 2008;54:409-418.
- Soroush R.S., Guilherme C.L., Ioannis M.V. Intraoperative conversion of laparoscopic partial nephrectomy. J Endourol. 2006;20:205-208.
- Ben X., Qian Z., Jie J. Retroperitoneal laparoscopic partial nephrectomy for moderately complex renal hilar tumors. Urol Int. 2014; 92:400-406.
- Venkatesh R., Weld K., Ames C.D., Figenshau S.R., Sundaram C.P., Andriole G.L., Clayman R.V., Landman J. Laparoscopic partial nephrectomy for renal masses: Effect of tumor location. Urology 2006;67:1169-1174.
- Zorn K.C., Gong E.M., Mendiola F.P., Mikhail A.A., Orvieto M.A., Gofrit O.N., Steinberg G.D., Shalhav A.L. Operative outcomes of upper pole laparoscopic partial nephrectomy: Comparison of lower pole laparoscopic and upper pole open partial nephrectomy. Urology 2007;70:28-34.
- Narayanan R., O’Malley R.L., Mehedint D., Schwaab T. Upper pole kidney tumors: Open or laparoscopic partial nephrectomy? J Clin. Oncol. 2012; 30 (Suppl. 5): Abstract 429.
- Kaplan J.R., Chang P., Percy A.G., Wagner A.A. Renal transposition during minimally invasive partial nephrectomy: a safe technique for excision of upper pole tumors. J. Endourol. 2013;27(9):1096-1100.
- Song S., Zhang H., Huang Y. et al. The application of renal pedicle rotation method in retroperitoneal laparoscopic PN for renal ventral tumors. J. Endourol. 2015;29(9):1038-1043.
Supplementary files
