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Laparoscopic radical nephrectomy for renal tumor: Experience in 530 cases.

Authors :
Ramani, Anup P.
Source :
Indian Journal of Urology; Supplement1, Vol. 24, pS11-S11, 1/3p
Publication Year :
2008

Abstract

Introduction: Laparoscopic radical nephrectomy (LRN) is now the standard of care for most patients with organ confined renal tumors. While LRN can be attempted by most urologists for the smaller renal tumor, the large tumors still require significant laparoscopic experience. Materials and Methods: Between January 2003 and March 2007, a total of 530 LRN were performed by the author or his fellows. All patients underwent appropriate staging and metastatic workup. Mean age was 54.7 years (39-77), 296 (55.8%) tumors were left sided, 413 patients (77.9%) were male. Mean tumor size was 6.5 cms (3-10.5). CT angiogram with 3D reconstruction was performed in every case. Results: 527 of the 530 cases (99.4) were completed laparoscopically. 3 patients required open conversion. 2 conversions were emergent to control sudden hemorrhage and one was elective due to non progress. 418 cases were transperitoneal and 112 cases were retroperitoneal. Mean operative time was 170 minutes (70-280), mean blood loss was 370 cc (50-2000), 17 patients (3.2%) required either intraoperative or postoperative blood transfusion. Mean hospital stay was 2.8 days (1-18). There were 31 (5.8%) minor complications and 8 (1.5%) major complications. Minor complications included ileus, pnueumothorax, post operative hematoma, cardiac failure, port site hernia and major complications included massive hemorrhage requiring open conversion, bowel injury at time of veres needle insertion, pneumonia. Mean follow up was 3.4 years (1-4). 2 patients had a local recurrence. Conclusions: LRN should be the standard of care for most patients with organ confined renal tumor. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
09701591
Volume :
24
Database :
Complementary Index
Journal :
Indian Journal of Urology
Publication Type :
Academic Journal
Accession number :
34754561