Retroperitoneal Laparoscopic Radical Nephrectomy for Large (&gt;7 cm) Solid Renal Tumors: Comparison of Perioperative Outcomes with the Transperitoneal Approach

Kim, Hee Youn; Lee, Dong Sup; Yoo, Je Mo; Lee, Woo Jung; Lee, Seung‐Ju

doi:10.1089/lap.2016.0689

Cited by 11 publications

(8 citation statements)

References 16 publications

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“…Blood loss in published series ranged from 0 to 828 ml. The lowest losses recorded by Oscar Schatloff et al [6] in a retrospective study including 129 patients admitted for laparoscopic nephrectomy, and the highest by Hee Youn Kim et al [7] in a comparative study of the retroperitoneal (34 patients) and transperitoneal (30 patients) pathways of laparoscopic radical nephrectomy for large solid renal tumors (> 7 cm).…”

Section: Discussionmentioning

confidence: 96%

Laparoscopic nephrectomy: Moroccan experience of 68 cases

Bilgo¹,

Saouli²,

Karmouni³

et al. 2021

Afr J Urol

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Background The aim of this study was to analyze the feasibility and the safety of laparoscopic nephrectomy in the treatment of pathologies of the upper urinary tract through the experience of the Urology B department. Methods We have retrospectively and monocentrally selected patients who underwent laparoscopic nephrectomy from January 2017 to December 2019. The collection was carried out on archived files, based on demographic, clinical and perioperative data. The primary endpoint was the occurrence of complications and secondarily the length of the operation and the length of hospital stay. The statistical analysis was carried out using the SPSS software. Results A total of 68 patients were included in our series. The average age of our patients was 57.8 years. There was a slight female predominance: 39 female patients (57.4%) for 29 male patients (42.6%). Indications for nephrectomy were dominated by renal tumor (33.82%) followed by lithiasis (16.17%) and non-functioning kidney (16.17%) at the same rank. During the study period, 31 (45.6%) simple nephrectomy, 26 (38.2%) total nephrectomy, 1 (1.5%) partial nephrectomy and 10 (14.7%) nephroureterectomy were performed in our department. In our series, the average operating time was 180 min. Estimated blood loss averaged 321.8 ml with extremes of a few milliliter to 1100 ml. Intraoperative complications were reported in 10 (14.7%) patients; conversion was necessary in 6 cases (8.82%). The postoperative follow-up was straightforward in 53 (77.94%) patients with an average hospital stay of 3.6 days. The rate of postoperative complications according to Clavien–Dindo was 22.1%. Histological examination of the nephrectomies carried out in our department revealed mainly chronic non-specific pyelonephritis in 24 (35.3%) patients, followed by renal cell carcinoma in 23 (33.82%) patients and urothelial carcinoma in 9 (13.2%) patients. Conclusion Laparoscopic nephrectomy appears to be an efficient and reliable technique. This technique has led to a significant improvement in operative morbidity, mainly represented by the length of hospital stay, operating time and blood loss.

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Section: Discussionmentioning

confidence: 96%

Laparoscopic nephrectomy: Moroccan experience of 68 cases

Bilgo¹,

Saouli²,

Karmouni³

et al. 2021

Afr J Urol

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“…In China, RLRN is more prevalent. Kim et al previously showed that RLRN achieved better perioperative outcomes than TLRN on the premise that the mean tumor volume was larger, suggesting that RLRN was feasible in patients with >7 cm tumor ( 8 ).…”

Section: Discussionmentioning

confidence: 99%

Retroperitoneal laparoscopic radical nephrectomy (RLRN) is associated with poor integrity of Gerota's fascia and perirenal fat: A prospective comparative study

et al. 2023

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PurposeTo figure out the difference of integrity of Gerota's fascia and perirenal fat between Retroperitoneal Laparoscopic Radical Nephrectomy (RLRN) and Transperitoneal Laparoscopic Radical Nephrectomy (TLRN).MethodsThis is a prospective comparative study of patients with Renal Cell Carcinoma (RCC) from a designated tertiary center in Lanzhou, China. We have developed and propose a scoring tool to quantify the integrity of nephrectomy specimens from both approaches. The integrity score is based on 6 common conditions of nephrectomy specimens. Specimens are scored on a 1 to 6-point scale according to the integrity of Gerota's fascia and perirenal fat. We applied the integrity score to 142 consecutive patients. Integrity scores were compared between RLRN and TLRN groups. Factors associated with low integrity score were assessed by logistic regression.ResultsAmong 142 patients, 79 (55.6%) patients and 63 (44.4%) patients, respectively, underwent RLRN and TLRN. There was a significant difference in the distribution of integrity score between the two groups (P < 0.001). RLRN (odds ratio 10.65, 95%CI 4.29–26.45, P < 0.001), tumor size (odds ratio 1.22, 95%CI 1.04–1.42, P = 0.015) and Body Mass Index (BMI) (odds ratio 0.83, 95%CI 0.72–0.96, P = 0.010) were significantly associated with low integrity score. The logistic regression equation showed good power to predict low integrity score.ConclusionRLRN has poor integrity of Gerota's fascia and the perirenal fat. The integrity score can be used to evaluate the extent of resection and specimen completeness in LRN. Postoperative evaluation of the integrity score is of great value for urologists to evaluate the risk of tumor residue.

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“…While a retrospective comparative study suggested improved operation times, blood loss, and time to commencement of diet with retroperitoneal LRN [12]; Recently published articles with prospective randomized series demonstrated no statistically difference in the overall operative morbidity in transperitoneal versus retroperitoneal radical nephrectomies [13][14][15][16]. Nevertheless it is remarkable that the retroperitoneal group, compared to the transperitoneal approach, was associated with a shorter total time to control the renal artery and quicker control of the renal vein [13].…”

Section: The Lower Pole Approach In Retroperitoneoscopic Radical Neph...mentioning

confidence: 99%

Operative Techniques and Outcomes in Laparoscopic Radical Nephrectomy

Sharma¹

2024

Current Concepts and Controversies in Laparoscopic Surgery

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Laparoscopic Radical Nephrectomy (LRN) is one of the commonest minimal access urological surgical procedures for renal malignancies. The procedure involves the complete removal of the affected kidney, together with the adrenal gland and surrounding Gerota’s fascia along with the ureter as distal as possible. Advantages of LRN includes decreased intra-operative blood loss, decreased post operative pain, speedy recovery and decreased duration of hospital stay. This chapter aims to describe all the operative steps in an illustrated manner and also to highlight the difficulties which may be encountered by beginners and how to troubleshoot the various difficulties and complications during the procedure.

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Retroperitoneal Laparoscopic Radical Nephrectomy for Large (>7 cm) Solid Renal Tumors: Comparison of Perioperative Outcomes with the Transperitoneal Approach

Cited by 11 publications

References 16 publications

Laparoscopic nephrectomy: Moroccan experience of 68 cases

Laparoscopic nephrectomy: Moroccan experience of 68 cases

Retroperitoneal laparoscopic radical nephrectomy (RLRN) is associated with poor integrity of Gerota's fascia and perirenal fat: A prospective comparative study

Operative Techniques and Outcomes in Laparoscopic Radical Nephrectomy

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