Hemostatic techniques during laparoscopic nephron-sparing surgery / 中华泌尿外科杂志

ABSTRACT

Objective To investigate the efficacy and safety of the hemostatic techniques applied during the laparoscopic nephron-spring surgery in the treatment of renal tumor. Methods Twentytwo male and 8 female patients with renal tumors underwent laparoscopic nephron-sparing surgery by using the hemostatic techniques of harmonic scalpel, bipolar cautery and renal parenchyma defect suturing over surgical bolsters. Among them, 4 cases have been done transperitoneally and others have been done retroperitoneally. The mean patient age was 50 years. Of the 30 cases, 20 had renal cell cancers with a mean diameter of 2.5 cm, and 10 had renal angiomyolioma with a mean diameter of 2.4 cm. The operating time, estimated blood loss, length of postoperative hospital stay, complications and surgical results were recorded. Results All procedures were successfully completed. No case had converted to open surgery. The mean operating time was 169min and mean estimated blood loss was 100 ml. Major complications happened in 2 patients. One of them had accepted transfusion during surgery. Another case had retroperitoneal hemorrhage three days after surgery and had been treated with 800 ml blood transfusion. The mean post-operative hospital stay was 9 days. During the mean 9 month follow-up, no patient had local or trocar port site recurrence.Conclusion The hemostatic techniques of harmonic scalpel, bipolar cautery, renal parenchyma defect suturing over surgical bolsters could be effectively and safely applied in the laparoscopic nephron-sparing surgery.