Clampless laparoscopic partial nephrectomy: a step towards a harmless nephron-sparing surgery?
Int. braz. j. urol
;
38(4): 480-488, July-Aug. 2012. ilus, tab
Article
in English
| LILACS
| ID: lil-649441
ABSTRACT
PURPOSE:
To evaluate the results of our technique of clampless laparoscopic partial nephrectomy (LPN) and its impact as an emerging treatment for small renal masses (SMRs). MATERIALS ANDMETHODS:
We reviewed our prospectively maintained database data of 117 patients who consecutively underwent LPN at our Institution from January 2009 to December 2011 were studied. Patients were divided into 2 Groups based on operative technique Group A clampless-LPN (cl-LPN); Group B conventional LPN (clamping of renal artery). Demographic and peri-operative data, complications, pre- and post-operative serum creatinine and estimated glomerular filtration rate (eGFR) were registered and compared by Student’s t- and Chi-square-tests (p-values < 0.05 considered statistically significant).RESULTS:
41 patients were in Group A and 76 in Group B. Groups were comparable in terms of preoperative data except for tumour’s size (2.35 ± 1.10 vs. 3.19 ± 1.57, Group A vs. B, respectively, p = 0.0029). Concerning perioperative data, warm ischemia time (WIT) was 0 min. in all Group A cases; mean WIT in Group B was 20.90 ± 9.27 min. One case (2.4%) in Group A (central tumour) was converted to conventional LPN. Mean eGFR postoperative decrease was higher in Group B (0.17 ± 9.30 vs. 4.38 ± 11.37 mL/min., A vs B, respectively, p = 0.0445).CONCLUSIONS:
Notwithstanding the limits of the study, our results suggest that cl-LPN is a safe and effective technique, which allows surgeon to surgically treat SRMs even in case of complex location, without injuring kidney by ischemia.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Laparoscopy
/
Organ Sparing Treatments
/
Nephrectomy
/
Nephrons
Type of study:
Observational study
Limits:
Aged
/
Female
/
Humans
/
Male
Language:
English
Journal:
Int. braz. j. urol
Journal subject:
Urology
Year:
2012
Type:
Article
Affiliation country:
Italy
Institution/Affiliation country:
San Luigi Gonzaga Hospital/IT
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