Retroperitoneal Laparoscopic Radical Nephrectomy: The Cleveland Clinic Experience

Gill, Inderbir S.; Schweizer, Dana; Hobart, Michael G.; Sung, Gyung Tak; Klein, Eric A.; Novick, Andrew C.

doi:10.1016/s0022-5347(05)67516-7

Cited by 197 publications

(110 citation statements)

References 14 publications

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“…The laparoscopic group returned earlier to normal activities, and full recovery was also reached more rapidly. Gill et al [43] compared radical laparoscopic (retroperitoneal) with open nephrectomy in 68 patients (2b). They used an ad hoc questionnaire.…”

Section: Nephrectomy For Malignancymentioning

confidence: 99%

Evaluation of quality of life after laparoscopic surgery: evidence-based guidelines of the European Association for Endoscopic Surgery

et al. 2004

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Background: Measuring health-related quality of life (QoL) after surgery is essential for decision making by patients, surgeons, and payers. The aim of this consensus conference was twofold. First, it was to determine for which diseases endoscopic surgery results in better postoperative QoL than open surgery. Second, it was to recommend QoL instruments for clinical research. Methods: An expert panel selected 12 conditions in which QoL and endoscopic surgery are important. For each condition, studies comparing endoscopic and open surgery in terms of QoL were identified. The expert panel reached consensus on the relative benefits of endoscopic surgery and recommended generic and disease-specific QoL instruments for use in clinical research. Results: Randomized trials indicate that QoL improves earlier after endoscopic than open surgery for gastroesophageal reflux disease (GERD), cholecystolithiasis, colorectal cancer, inguinal hernia, obesity (gastric bypass), and uterine disorders that require hysterectomy. For spleen, prostate, malignant kidney, benign colorectal, and benign non-GERD esophageal diseases, evidence from nonrandomized trials supports the use of laparoscopic surgery. However, many studies failed to collect long-term results, used nonvalidated questionnaires, or measured QoL components only incompletely.

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Section: Nephrectomy For Malignancymentioning

confidence: 99%

Evaluation of quality of life after laparoscopic surgery: evidence-based guidelines of the European Association for Endoscopic Surgery

et al. 2004

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“…reported excellent results in retroperitoneal laparoscopic radical nephrectomy. 8 The average operating time was 2.9 h and estimated blood loss 128 mL. These results were thought to be due to superior technique following a great deal of experience of various kinds of laparoscopic surgery.…”

Section: Discussionmentioning

confidence: 99%

“…reported that retroperitoneoscopy offered several unique advantages, including expeditious access to the renal artery and vein allowing early ligation, extra fascial mobilization of the kidney and en bloc removal of the adrenal gland, recapitulating the principle of open surgery. 8 Despite these advantages, the technical difficulties have also been debated including the smaller working space of the retroperitoneum and the lack of well-defined anatomical landmarks.…”

Section: Introductionmentioning

confidence: 99%

Hand‐assisted retroperitoneoscopic radical nephrectomy: Initial experience

et al. 2002

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Objectives : To report our initial experience of hand-assisted retroperitoneoscopic radical nephrectomy for stage T1 renal tumors. Methods : The clinical data on 22 consecutive patients who had undergone hand-assisted retroperitoneoscopic radical nephrectomy and 22 who had undergone open radical nephrectomy were reviewed. The operation was performed with a hand placed retroperitoneally through a pararectal longitudal 7-7.5 cm incision using a LAP DISC.Results : The total operating time was between 2.3 and 5.8 h (mean: 3.4 h). The estimated blood loss was between 15 and 650 mL (mean: 170 mL). The complication rate was 9% (2/22). No conversions to open procedure occurred. In comparison to open radical nephrectomy, the operating time was similar (3.4 vs 3.9 h) whereas the estimated blood loss was significantly less in this procedure (170 vs 495 mL). During the convalescence period the patients revealed significantly less postoperative pain, shorter intervals to resuming oral intake and more rapid return to normal activities compared to the open radical nephrectomy patients. Conclusion : Hand-assisted retroperitoneoscopic radical nephrectomy is an effective and safe procedure for T1 renal tumors.

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“…Interestingly, retroperitoneal LRN for T1 RCC offered several advantages, with statistical differences from open surgery. Reports worldwide confirm the benefits of this less invasive procedure and comparisons between LRN and open RN have consistently shown advantages for the former approach in all indices of perioperative morbidity, including estimated blood loss, postoperative narcotic requirement, length of hospitalization and duration of convalescence [6,7,[11][12][13][14][15][16][17][18][19].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic radical nephrectomy for T1 renal cancer: the gold standard? A comparison of laparoscopic vs open nephrectomy

et al. 2003

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recurrence, were compared between the groups. RESULTSThere were no differences between the laparoscopic and open groups in age, sex ratio, weight, height, fitness score, operative duration (134 vs 133 min), minor or major complications, tumour diameter, Fuhrman grade or length of follow-up. Patients who underwent laparoscopic surgery had less blood loss (133 vs 357 mL, P < 0.001), less need for transfusion (none vs 150 mL, P = 0.04), a lower consumption of analgesia drugs, and shorter hospitalization (5.5 vs 8.8 days, P < 0.001). With a mean follow-up of 20.4 months there was no recurrence or tumour progression. CONCLUSIONLaparoscopic radical nephrectomy for patients with T1 renal cancer is a safe, reliable procedure that decreases hospitalization time and bleeding, and ensures the same cancer control as open nephrectomy.

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Retroperitoneal Laparoscopic Radical Nephrectomy: The Cleveland Clinic Experience

Abstract: Retroperitoneoscopy is a reliable, effective and, in our hands, the preferred technique of laparoscopic radical nephrectomy. At our institution retroperitoneoscopy has emerged as an attractive alternative to open radical nephrectomy in patients with T1-T2N0M0 renal tumors.

Cited by 197 publications

References 14 publications

Evaluation of quality of life after laparoscopic surgery: evidence-based guidelines of the European Association for Endoscopic Surgery

Evaluation of quality of life after laparoscopic surgery: evidence-based guidelines of the European Association for Endoscopic Surgery

Hand‐assisted retroperitoneoscopic radical nephrectomy: Initial experience

Laparoscopic radical nephrectomy for T1 renal cancer: the gold standard? A comparison of laparoscopic vs open nephrectomy

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