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Paper Information

Journal:   UROLOGY JOURNAL   March-April 2019 , Volume 16 , Number 2; Page(s) 128 To 133.

Our Results of Laparoscopic Partial Nephrectomies Without Pedicle Dissection: Possible Advantages and Disadvantages



Author(s):  Verit Ayhan, Urkmez Ahmet*, Yuksel ozgur Haki, Uruc Fatih
* Istanbul Haydarpasa Numune Hospital SAUM, Dept. of Urology, Uskudar Tr- 34668 Istanbul, Turkey
Purpose: This study aimed to document the surgical and oncologic results of nephron sparing of non-ischemic laparoscopic partial nephrectomy without the step of hilus controlling and even without dissecting to expose the main renal vascularity and directly focusing on mass removal. Materials & Methods: The records of the patients who underwent our modified laparoscopic partial nephrectomy technique were evaluated retrospectively. The patients’ medical records, including tumor complexity calculated via R. E. N. A. L nephrometry scores, operation time, estimated blood loss, blood transfusions, hospital stay, pre-and postoperative serum creatinine levels, complications via the Clavien classification system, pathological status of surgical margin, and follow-up times, were documented. Result: The data of 55 patients with 58 renal units were evaluated. Almost all tumors were in the low complex group (91%), with a mean size of 31. 74 ± 7. 38 mm (range: 12-46 mm). Mean operation time, estimated blood loss, and transfusion rates were 138. 62 ± 38. 45 minutes (range: 90-240 min), 242. 24 ± 107. 12 mL (range: 100-500 mL), and 19%, respectively. The hemoglobin level decreased by a mean of 2. 05 ± 0. 87 g/dL. Whereas the perioperative complications were Clavien grades I, II, and III (74%, 23%, and 3%, respectively), mean hospital stay and follow-up time were 4. 05 ± 1. 97 and 19. 67 ± 13. 57 (ranges: 2-10 days and 1-44 months), respectively. Conclusion: Present un-controlled results pointed that tumor-focusing nephron-sparing non-ischemic partial laparoscopic nephrectomy may be preferable for small-sized, low-complex renal masses.
Keyword(s): laparoscopic partial nephrectomy,renal hilus dissection,tumor-focusing laparoscopy,zero ischemia
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