Önder ÇINAR
(Zonguldak Bülent Ecevit Üniversitesi, Üroloji Bölümü, Zonguldak, Türkiye)
Engin Denizhan DEMİRKIRAN
(Zonguldak Bülent Ecevit Üniversitesi, Üroloji Bölümü, Zonguldak, Türkiye)
Ersan BULUT
(Zonguldak Bülent Ecevit Üniversitesi, Üroloji Bölümü, Zonguldak, Türkiye)
Mustafa BOLAT
(Samsun Gazi Devlet Hastanesi, Üroloji Kliniği, Samsun, Türkiye)
Bülent AKDUMAN
(Zonguldak Bülent Ecevit Üniversitesi, Üroloji Bölümü, Zonguldak, Türkiye)
N. Aydın MUNGAN
(Zonguldak Bülent Ecevit Üniversitesi, Üroloji Bölümü, Zonguldak, Türkiye)
Yıl: 2020Cilt: 7Sayı: 1ISSN: 2148-9580Sayfa Aralığı: 16 - 20İngilizce

35 0
Laparoscopic Transperitoneal Simple, Radical and Partial Nephrectomy: A Single Center Experience
Objective: To present our initial experience on laparoscopic transperitoneal nephrectomies and to report the perioperative and postoperative outcomes in patients with kidney tumor. Materials and Methods: We retrospectively evaluated clinical data, laboratory results and radiological findings of 40 patients who underwent laparoscopic renal surgery performed by a single surgeon in a single center between November 2017 and May 2019. Thoracoabdominopelvic computed tomography was performed in all patients. Results: A total of 40 patients (26 males (65%), 14 females (35%) with a median age of 58.7 years underwent laparoscopic transperitoneal nephrectomy. Sixteen patients underwent laparoscopic simple nephrectomy (LSN) for nonfunctional kidney, 20 patients with solid renal tumors underwent laparoscopic radical nephrectomy (LRN), and four patients underwent laparoscopic partial nephrectomy (LPN) for solid renal mass. The mean operative time was 207.9±79.1, 218.9±57.5 and 175.0±75.0 minutes for LSN, LRN and LPN, respectively. The mean length of hospital stays was 3.0±1.3, 2.7±0.6 and 2.7±1.5 days, respectively. Conversion to open surgery was done in 2 patients who underwent LRN and in two patients who underwent LSN due to intraoperative bleeding and intraperitoneal adhesions, respectively. We experienced postoperative complication only in one patient (2.5%) who underwent LSN. Conclusion: Advances in technology and surgical experience have led to an increase in laparoscopic kidney surgery even for advanced renal tumors. Serious complications may occur mainly in the early stages of the learning curve, but complication rates and operative time significantly decrease by the surgeons’ experience. Complicated and more extensive tumors make surgeons more experienced in advanced laparoscopic treatment techniques.
DergiAraştırma MakalesiErişime Açık
  • 1. Ljungberg B, Bensalah K, Canfield S, Dabestani S, Hofmann F, Hora M, Kuczyk MA, Lam T, Marconi L, Merseburger AS, Mulders P, Powles T, Staehler M, Volpe A, Bex A. EAU guidelines on renal cell carcinoma: 2014 update. Eur Urol 2015;67:913–924.
  • 2. Campbell S, Uzzo RG, Allaf ME, Bass EB, Cadeddu JA, Chang A, Clark PE, Davis BJ, Derweesh IH, Giambarresi L, Gervais DA, Hu SL, Lane BR, Leibovich BC, Pierorazio PM. Renal Mass and Localized Renal Cancer: AUA Guideline. J Urol 2017;198:520-529.
  • 3. Van Poppel H, Becker F, Cadeddu JA, Gill IS, Janetschek G, Jewett MA, Laguna MP, Marberger M, Montorsi F, Polascik TJ, Ukimura O, Zhu G. Treatment of localised renal cell carcinoma. Eur Urol 2011;60:662-672.
  • 4. Nguyen CT, Campbell SC, Novick AC. Choice of operation for clinically localized renal tumor. Urol Clin North Am 2008;35:645-655.
  • 5. Liu G, Ma Y, Wang S, Han X, Gao D. Laparoscopic Versus Open Radical Nephrectomy for Renal Cell Carcinoma: a Systematic Review and MetaAnalysis. Transl Oncol 2017;10:501-510.
  • 6. Liu F, Guo W, Zhou X, Ding Y, Ma Y, Hou Y, Kong X, Wang Z. Laparoscopic versus open nephroureterectomy for upper urinary tract urothelial carcinoma: A systematic review and meta-analysis. Medicine (Baltimore) 2018;97:e11954.
  • 7. Nadu A, Mor Y, Chen J, Sofer M, Golomb J, Ramon J. Laparoscopic nephrectomy: initial experience in Israel with 110 cases. Isr Med Assoc J 2005;7:431-434.
  • 8. Hemal AK, Kumar A, Kumar R, Wadhwa P, Seth A, Gupta NP. Laparoscopic versus open radical nephrectomy for large renal tumors: a longterm prospective comparison. J Urol 2007;177:862-866.
  • 9. Brewer K, O’Malley RL, Hayn M, Safwat MW, Kim H, Underwood W 3rd, Schwaab T. Perioperative and renal function outcomes of minimally invasive partial nephrectomy for T1b and T2a kidney tumors. J Endourol 2012;26:244-248.
  • 10. Sprenkle PC, Power N, Ghoneim T, Touijer KA, Dalbagni G, Russo P, Coleman JA. Comparison of open and minimally invasive partial nephrectomy for renal tumors 4-7 centimeters. Eur Urol 2012;61:593-599.
  • 11. Ha US, Hwang TK, Kim YJ, Oh TH, Jeon YS, Lee W, Lim JS, Lee TY, Choi Y, Park SK, Byun SS. Comparison of oncological outcomes of transperitoneal and retroperitoneal laparoscopic radical nephrectomy for the management of clear-cell renal cell carcinoma: a multi-institutional study. BJU Int 2011;107:1467-1472.
  • 12. McAllister M, Bhayani SB, Ong A, Jaffe W, Malkowicz SB, VanArsdalen K, Chow GK, Jarrett TW. Vena caval transection during retroperitoneoscopic nephrectomy: report of the complication and review of the literature. J Urol 2004;172:183-185.
  • 13. Demir Ö, Öztürk B, Egriboyun S, Esen A. Kliniğimizde Laparoskopik Cerrahide İlk Deneyimlerimiz Ve Öğrenme Süreci. Dokuz Eylül Tıp Fakültesi Dergisi 2010;24:105-112.
  • 14. Rassweiler J, Fornara P, Weber M, Janetschek G, Fahlenkamp D, Henkel T, Beer M, Stackl W, Boeckmann W, Recker F, Lampel A, Fischer C, Humke U, Miller K. Laparoscopic nephrectomy: the experience of the laparoscopic working group of the German Urological Association. J Urol 1998;160:18- 21.
  • 15. Abbou CC, Cicco A, Gasman D, Hoznek A, Antiphon P, Chopin DK, Salomon L. Retroperitoneal laparoscopic versus open radical nephrectomy. J Urol 1999;161:1776-1780.
  • 16. Ono Y, Kinukawa T, Hattori R, Gotoh M, Kamihira O, Ohshima S. The longterm outcome of laparoscopic radical nephrectomy for small renal cell carcinoma. J Urol 2001;165:1867-1870.
  • 17. Chan DY, Cadeddu JA, Jarrett TW, Marshall FF, Kavoussi LR. Laparoscopic radical nephrectomy: cancer control for renal cell carcinoma. J Urol 2001;166:2095-2099.
  • 18. Gill IS, Meraney AM, Schweizer DK, Savage SS, Hobart MG, Sung GT, Nelson D, Novick AC. Laparoscopic radical nephrectomy in 100 patients: a single center experience from the United States. Cancer. 2001;92:1843-1855.
  • 19. Soulie M, Seguin P, Richeux L, Mouly P, Vazzoler N, Pontonnier F, Plante P. Urological complications of laparoscopic surgery: experience with 350 procedures at a single center. J Urol 2001;165:1960-1963.
  • 20. Simon SD, Castle EP, Ferrigni RG, Lamm DL, Swanson SK, Novicki DE, Andrews PE. Complications of laparoscopic nephrectomy: the Mayo clinic experience. J Urol 2004;171:1447-1450.
  • 21. Akkoc A, Topaktas R, Aydin C, Altin S, Girgin R, Yagli OF, Sentürk AB, Metin A. Which intraperitoneal insufflation pressure should be used for less postoperative pain in transperitoneal laparoscopic urologic surgeries? Int Braz J Urol 2017;43:518-524.
  • 22. Gill IS, Kavoussi LR, Clayman RV, Ehrlich R, Evans R, Fuchs G, Gersham A, Hulbert JC, McDougall EM, Rosenthal T, Schuessler WW, Shepard T. Complications of laparoscopic nephrectomy in 185 patients: a multiinstitutional review. J Urol 1995;154:479–483.
  • 23. Siqueira Jr TM, Kuo RL, Gardner TA, Paterson LH, Stevens LH, Lingeman JE, Koch MO, Shalhav AL. Major complications in 213 laparoscopic nephrectomy cases: the Indianapolis experience. J Urol 2002;168:1361–1365.
  • 24. Colombo Jr JR, Haber GP, Jelovsek JE, Nguyen M, Fergany A, Desai MM, Kaouk JH, Gill IS. Complications of laparoscopic surgery for urological cancer: a single institution analysis. J Urol 2007;178:786–791.

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