Nefrectomía radical lumboscópica: experiencia inicial en el Servicio de Urología del Hospital de Especialidades del Centro Médico Nacional Siglo XXI del IMSS.

Objective: To present the initial experience on lumboscopic radical nephrectomy in our hospital. Materials and methods: We reviewed the clinical files of 18 patients who underwent a radical lumboscopic nephrectomy at Urology Service of the Hospital de Especialidades del Centro Médico Nacional Siglo XXI from October 2003 to October 2005. Results: In total, 18 patients underwent a lumboscopic radical nephrectomy. The mean operative time was 2 hours 50 min and transoperatory bleeding of 80 cc. In two cases was necessary to convert to open surgery for the completion of the procedure. There was no perioperative mortality. The hospital stay was 2.6 days, the 24 hour postoperative pain rate, measured by an analogous pain scale from 0 to 10 was 3.5. The mean tumoral diameter was 5.6 cm. The pathological study showed renal clear cell carcinoma in 17 cases and a sarcomatoid renal cell carcinoma in one patient. The final pathological stages of the patients with renal clear cell carcinoma, according to the TNM classification system were: T1, N0, M0 in 9 cases, T2, N0, M0 in 6 and T3a, N0, M0 in 2. Conclusions: The lumboscopic radical nephrectomy has several advantages over the open approach: less transoperatory bleeding, shorter hospital stay and lower analgesic requirement. Compared to the transperitoneal approach lumboscopy reduces the incidence of intra-abdominal complications. In our country, this is the first series of lumboscopic radical nephrectomy. A larger number of cases as well as a longer follow-up are necessary to precisely assess this surgical approach. [ABSTRACT FROM AUTHOR]