Clinical application of transperitoneal laparoendoscopic single-site nephrectomy / 中华泌尿外科杂志

Objective　To verify the safety and feasibility of applying transperitoneal laparoendoscopic single-site surgery (LESS) nephrectomy in the treatment of kidney malignant and benign diseases.Methods　From Nov.2010 to Jun.2012,we had used LESS nephrectomy technique treated four kidney tumors,one renal pelvic tumor and one atrophic kidney. Quadport was introduced into abdominal cavity through a paraumbilical incision. Conventional laparoscopic instruments,prebent laparoscopic instruments and flexible tip 5mm laparoscope were used. The standard laparoscopic transperitoneal nephrectomy technique was then performed.We evaluated this technique in respects of operative time,estimated blood loss,intraoperative complications,1st post-operative day pain (VAPS),drainage time,post-operative hospital stay and pathological results.　Results　The 6 procedures in this group were completed successfully with LESS nephrectomy. There was no additional trocar added,no conversion to conventional laparoscopic or open surgery.Application of Quadport and prebent instruments reduced the clash of instruments,both intracorporally and extracorporally.The average operative time were 181.7 (145.0 -235.0) min,average estimated blood loss were 78.3 (20.0 - 150.0) ml.There was no severe intraoperative complication.The average VAPS in the first post - operative day was 1.7 ( 1.0 - 2.0).The average drainage time was 2.8 ( 1.0 -4.0) d,post-operative hospital stays was 6.8 ( 1.0 - 10.0) d.There was no secondary bleeding or wound infection.Pathological results showed 3 cases of renal clear cell carcinoma,1 case of chromophobic carcinoma,1 case of high-grade urothelial carcinoma and 1 case of atrophic kidney.All the specimens in this group were surgical margin negative.　Conclusions　LESS nephrectomy is a safe and feasible treatment option for the treatment of kidney surgical diseases.

The Angiographic Evaluation in Renal Pelvic Tumor / 대한비뇨기과학회지

Early detection of renal pelvic tumor is essential since the survival rate is markedly reduced if the lesion has invaded beyond the pelvic wall. Accurate preoperative diagnosis is of considerable practical importance. since the surgeon should choose an unique operative approach conducive to a nepbroureterectomy with removal of a cuff of bladder. Selective renal angiography plays an important role in the diagnosis of renal tumor, but little is known about the importance of selective renal angiography in renal pelvic tumor. We performed selective renal angiography in 9 patients with clinically diagnosed renal pelvic tumor in this department during 2 years and 4 months period from March 1979 to June 1981. 7 out of 9 patients were diagnosed with transitional cell carcinoma of the renal pelvis histologically and remaining 2, leiomyoma of the renal parenchyma and renal cell carcinoma. The angiographic findings in 7 patients with transitional cell carcinoma showed hypertrophy of the pelviureteral artery and a diminished branching of vessels in 5, respectively, and defects in the nephrographic phase, neovascularity and vascular displacement in 2 each.