• Journal of endourology · Dec 2009

    Clinical Trial

    Retroperitoneal laparoscopic partial nephrectomy for renal-cell carcinoma in a solitary kidney: report of 56 cases.

    • Jun-Hua Zheng, Yun-Fei Xu, Bo Peng, Hai-Min Zhang, Yang Yan, Qi-Ruo Gao, Jun Meng, and Jian-Hua Huang.
    • Department of Urology, Shanghai 10th People's Hospital, Tongji University, Shanghai, People's Republic of China. zhengjh0471@sina.com.cn
    • J. Endourol. 2009 Dec 1; 23 (12): 1971-4.

    ObjectiveThe aim of this study was to evaluate the possibility and clinical efficacy of retroperitoneal laparoscopic partial nephrectomy for T(1)- and T(2)-stage renal-cell carcinoma (RCC) of a solitary kidney.Patients And MethodsA total of 56 patients with RCC in a solitary kidney were selected in this study, including 41 men and 15 women with a mean age of 49 years. B-type ultrasonography and CT revealed T(1)N(0)M(0) tumors in 51 cases and T(2)N(0)M(0) tumors in the remaining 5 cases; 41 cases were RCC in left kidney, and 15 were RCC in right kidney. Of them, 24 cases had RCC located in the upper pole, 24 in the inferior pole, and 8 in the central region of the kidney. The mean tumor diameter was 3.0 +/- 0.8 cm (1.5-5.5 cm). Postoperative pathology report showed 46 cases of T(1)-stage tumor (T(1a): 38; T(1b): 8) and 10 cases of T(2) stage. Retroperitoneal laparoscopic nephron-sparing surgery was performed. Surgical resection was performed along a resection line 0.5 cm from the tumors. Renal function was determined using emission CT before and after operation. Preoperative three-dimensional CT image reconstruction was performed using multislice spiral CT.ResultsAll procedures were successfully performed without open conversion and serious complications. The mean warm ischemia time was 24 +/- 4.2 minutes (19-50 minutes). The mean operation time was 95 +/- 14.5 minutes. The mean blood loss volume was 105 +/- 20.4 mL. No postoperative urine leakage occurred. Both serum creatinine and nitrogen levels were normal after operation in all cases. The mean hospital stay was 9 +/- 2 days. There was no requirement for hemodialysis. No recurrence, metastasis, and implantation were observed during the 20 +/- 4 month follow-up periods, with a survival rate of 100%.ConclusionsLaparoscopic partial nephrectomy can be performed safely and effectively in selected patients with tumors in a solitary kidney owing to its minimal invasion, clear dissection, less hemorrhage, and rapid recovery.

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