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3.
Actas Urol Esp ; 34(3): 238-41, 2010 Mar.
Article in Spanish | MEDLINE | ID: mdl-20416240

ABSTRACT

INTRODUCTION: Laparoscopic nephron-sparing surgery is among the most complex urological procedures currently performed. Open surgery continues to be the gold standard of care, but the laparoscopic approach is gaining ground slowly but surely. Our 5 years' experience is reported. MATERIALS AND METHODS: From September 2004 to March 2009, 38 laparoscopic nephron-sparing procedures were performed at our hospital. A transperitoneal laparoscopic approach was used in all cases, with en bloc clamping of renal hilum in most patients. RESULTS: Mean operating time was 141 min, mean intraoperative bleeding 130 mL, mean warm ischemia time 24 min, and mean hospital stay 3.3 days. Bleeding was the most common complication (requiring transfusion in 13.5% of patients). Positive surgical margins were found in 5.4% of patients. CONCLUSIONS: Adequate selection of the patient (tumor size, location) and the procedure to be used, surgeon experience, and surgical skills are essential for achieving good oncological results and for minimizing the complications of this demanding procedure.


Subject(s)
Kidney Neoplasms/surgery , Laparoscopy , Nephrectomy/methods , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Nephrons , Time Factors
4.
Actas urol. esp ; 34(3): 238-241, mar. 2010. graf, tab
Article in Spanish | IBECS | ID: ibc-81695

ABSTRACT

Objetivo: La cirugía renal conservadora de parénquima laparoscópica es una de las técnicas más complejas que se pueden realizar en Urología en el momento actual. En la actualidad, la técnica abierta continúa siendo el gold standard, aunque lentamente la laparoscopia se va implantando. Presentamos nuestra serie de casi 5 años. Material y métodos: Desde septiembre de 2004 hasta marzo de 2009 se han realizado 38 cirugías conservadoras de parénquima renal por vía laparoscópica. Todas ellas se han realizado con el abordaje transperitoneal, con un clampaje en bloque del hilio renal en la mayoría de los casos. Resultados: El tiempo quirúrgico medio es de 141min, sangrado intraoperatorio medio de 130cm3, con un tiempo medio de clampaje de 24min y una estancia media postoperatoria de 3,3 días. La complicación más frecuente es el sangrado (transfusión, el 13,5%). El porcentaje de márgenes positivos es del 5,4%. Conclusiones: Con el fin de obtener unos buenos resultados oncológicos y reducir al mínimo las complicaciones, es fundamental la buena selección del caso (tamaño y localización del tumor) así como de la técnica que se va a emplear. La experiencia del cirujano y sus recursos laparoscópicos son de vital importancia (AU)


Introduction: Laparoscopic nephron-sparing surgery is among the most complex urological procedures currently performed. Open surgery continues to be the gold standard of care, but the laparoscopic approach is gaining ground slowly but surely. Our 5 years’ experience is reported. Materials and Methods: From September 2004 to March 2009, 38 laparoscopic nephron-sparing procedures were performed at our hospital. A transperitoneal laparoscopic approach was used in all cases, with en bloc clamping of renal hilum in most patients. Results: Mean operating time was 141min, mean intraoperative bleeding 130mL, mean warm ischemia time 24min, and mean hospital stay 3.3 days. Bleeding was the most common complication (requiring transfusion in 13.5% of patients). Positive surgical margins were found in 5.4% of patients. Conclusions: Adequate selection of the patient (tumor size, location) and the procedure to be used, surgeon experience, and surgical skills are essential for achieving good oncological results and for minimizing the complications of this demanding procedure (AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Kidney Neoplasms/surgery , Nephrectomy/methods , Laparoscopy/methods , Urinary Catheterization , Age and Sex Distribution , Kidney Neoplasms/epidemiology
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