Retroperitoneal laparoscopic partial nephrectomy combined with auxiliary small-incision and real-time B ultrasonic imaging in treatment of central renal cell carcinoma: A report of 12 cases / 第二军医大学学报

ABSTRACT

Objective To evaluate the clinical efficiency of retroperitoneal laparoscopic partial nephrectomy combinedwith auxiliary small-incision and real-time B ultrasonic imaging in treatment of central renal cell carcinoma and to summarize the surgical experience. Methods The clinical data of 12 patients (9 males and 3 females) with central renal cell carcinoma, who were treated from Aug. 2010 to Mar. 2012, were retrospectively analyzed. The patients had a mean age of (56.2±2.8) years old and a mean tumor diameter of (2.2±1.4) cm. The patients underwent preoperative ultrasonograpy, CT, MRI or CT angiography. The renal artery, renal vein and kidney were separated under general anesthesia. A small incision was made between A(posterior axillary line) and B(anterior axillary line) Trocar. The tumor location and the operative margin were determined by auxiliary real-time B ultrasound placed on the kidney surface via the incision. Ice slush was scattered around the kidney and nephron-sparing operation was done after blocking renal artery. Results All the 12 cases were operated successfully and the renal tumors were removed completely, with the mean operation time being (124.5±5.8) min, mean warm ischemia time (WIT) being (26.3±8.6) min, mean blood loss being (65.8±21.6) mL, mean incision length being (8.8±2.4) cm, and mean postoperative hospital stay being (12.4±2.6) d. All the patients had a negative surgical margin and there were no severe perioperative complications. All the patients had normal renal function and had no tumor recurrence or metastasis during a mean follow-up of (13.6±7.4) months. Conclusion Retroperitoneal laparoscopic partial nephrectomy combined with auxiliary small- incision and real-time B ultrasonic imaging is safe and effective for treatment of patients with central renal cell carcinoma, with less trauma, less blood loss, shorter WIT, and faster recovery, and it has a promising clinical future.