[Combined approach of laparoscopic and open surgery for complex renal lesions].
نویسندگان
چکیده
OBJECTIVE To develop a combined surgical approach (laparoscopic and open) that allows an increased vascular control and decreased ischemia time, maintaining the advantages of pure laparoscopic partial nephrectomy (LPN). MATERIAL AND METHODS During the laparoscopic phase, dissection of the kidney and its pedicle is achieved. Then, an open approach is initiated through a mini-laparotomy, with the kidney being brought to the incision, improving the identification and exposition of the tumors. Following tumor identification by ultrasound, exeresis of the lesion is performed with or without vascular clamping. RESULTS Through this approach we performed the excision of complex lesions in 6 patients. Mean surgical time was 192 minutes (range 180-210) and mean warm ischemia time was 13 minutes (0-22), with a mean blood loss of 267 mL (100-500). Average pre and postoperative glomerular filtration rate was 51.5 (28-90) and 48.8 mL/min/1.73 m(2) (19-90), respectively. In one patient, suture repair of the pelvicaliceal system was needed, with no other perioperative morbidities being reported. CONCLUSIONS This combined approach is a minimally invasive surgical alternative, reproducible and safe which preserves the virtues of pure LPN. It allows a better control of the vascular pedicle, reducing the risk of hemorrhage and the warm ischemia time. This technique may be either considered in the treatment of renal masses with indication for partial nephrectomy but of complex laparoscopic approach or as a surgical approach in the early learning curve of the LPN.
منابع مشابه
Comparison of Laparoscopic Versus Conventional Open Partial Nephrectomy in Dogs
Objective- Laparoscopic partial nephrectomy (LPN) has been proven to be a safe and effective technique in human. This study was conducted to evaluate the feasibility and safety of utilizing laparoscopic partial nephrectomy in dogs and to compare this technique with open routine partial nephrectomy for the first time in Iran. Design- Experimental study. Animals- Sixteen large mixed-breed femal...
متن کاملLaparoscopic Colon Surgery for Benign Disease: A Comparison to Open Surgery
Backgrounds and Objectives: Today we are witnessed a growing number of minimally invasive surgical techniques for different diseases. Laparoscopic colon surgery as a minimally invasive surgery is currently growing in treatment of malignancies after proving his place in the treatment of benign diseases. We compare in this study results of laparoscopic colorectal surgery with open surgery. Method...
متن کاملClinical and paraclinical evaluation of partial nephrectomy using laparoscopy and open surgery in dogs: new suturing technique
Partial nephrectomy, using open surgery or laparoscopy, is a standard surgical approach to treat renal disorders. The objective of this study was to compare and evaluate the feasibility and safety of laparoscopic partial nephrectomy using figure eight ligation technique. Mixed-breed dogs were randomly dedicated for partial nephrectomy using laparoscopy (n=6) and open surgery (n=6). During 30 da...
متن کاملAn investigational study about the conversion risk factors of laparoscopic cholecystectomy to open surgery
Background: Knowing the conversion risk factors of laparoscopic cholecystectomy to open surgery, helps the surgeon to plan for surgery accordingly. This study aimed to determine the risk factors for converting laparoscopic cholecystectomy to open surgery. Methods: In this analytical study, the case information of 1104 patients who underwent laparoscopic cholecystectomy in Shahid Beheshti Hospi...
متن کاملعوارض و ماندگاری کاتترگذاری دیالیز صفاقی بهروش لاپاراسکوپی در بیماران تحت دیالیز صفاقی مداوم
Background: Laparoscopic techniques for the placement of peritoneal dialysis catheters are becoming increasingly popular. Recently, with the improvements in laparoscopic surgery, various methods for the insertion of peritoneal dialysis catheters have been reported, indicating that the laparoscopic insertion is preferred over the open and percutaneous techniques. The aim of this study was to int...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Actas urologicas espanolas
دوره 37 2 شماره
صفحات -
تاریخ انتشار 2013