Laparoscopic partial nephrectomy for cancer: techniques and outcomes

Abstract

Open partial nephrectomy is the gold standard nephron-sparing treatment for small renal tumors. Technical aspects of laparoscopic partial nephrectomy have evolved considerably, and the technique is approaching established status at our institution. Over the past 4 years, the senior author has performed more than 400 laparoscopic partial nephrectomies at the Cleveland Clinic. Herein we present our current technique and review contemporary outcome data.

Different from Renal Artery Only Clamping, Artery and Vein Clamping Causes a Significant Reduction in Number of Rat Glomeruli During Warm Ischemia

“…2 Renal WI can be performed using artery only (AO) clamping 3,8,9 or artery and venous (AV) clamping together. 4,7,10,11 Although Plaine and Hinman 12 found no difference in renal function between AO and AV occlusion in rabbits, other studies in the porcine model demonstrated that the AV occlusion is more harmful for renal function, suggesting that the open renal vein enables retrograde perfusion and avoids venous congestion of the kidney. [13][14][15] Renal vein only occlusion in rats resulted in a more severe functional injury than AO occlusion.…”

Efficiency and Reliability of Laparoscopic Partial Nephrectomy for Renal Tumors Larger than 4 cm

“…Birçok yazar güvenli cerrahi sınırın tümör kapsülünün en az 0,5-1,0 cm uzağı olduğunu belirtmişlerdir (9,14,15). Duvdevani ve ark.…”

“…Bu çalışmada LPN'nin >4 cm'den büyük BHK'lerde etkinliği ve güvenilirliğini araştırmayı amaçladık. (14). Hastaların 3. ay kontrol kreatinin değerlerinde preoperatif değerlerle karşılaştırıldığında artış görülmemesinin en önemli sebebi olarak kısa iskemi süresini görmekteyiz.…”

Renal cell carcinoma with an emphasis on drug therapy of advanced disease, part 1

“…14 Laparoscopic nephrectomy, which is associated with less pain and a quicker recovery period, has been explored in a number of institutions for the removal of small lesions. 15,16 Laparoscopic surgery is associated with significantly shorter procedures and less blood loss and requires less postoperative analgesia and a shorter hospital stay. Laparoscopic surgery has evolved to the point that some clinicians suggest it as the procedure of choice for patients with localized disease that cannot be managed with a partial nephrectomy.…”