Laparoscopic Versus Open Radical Nephrectomy: A 9-Year Experience

Dunn, Matthew D.; Portis, Andrew J.; Shalhav, Arieh L.; Elbahnasy, Abdelhamid M.; Heidorn, Cindy; McDougall, Elspeth M.; Clayman, Ralph V.

doi:10.1097/00005392-200010000-00006

Cited by 119 publications

(170 citation statements)

References 18 publications

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“…Since the introduction of laparoscopic cholecystectomy in 1987 [24,25], minimally invasive surgery has been progressively applied to various benign gastrointestinal conditions [26,27] and to solid organs, such as the spleen [28,29], kidney [30,31], pancreas [32], and adrenal gland [33,34]. The role of laparoscopic surgery has already been emphasized for benign cystic liver diseases, such as congenital liver cysts [35][36][37].…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic liver resection of benign liver tumors

et al. 2003

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Laparoscopic resection of benign liver tumors is feasible and safe for selected patients with small tumors located in the left lateral segments or in the anterior segments of the right liver. Despite the use of a laparoscopic approach, selective indications for resection of benign liver tumors should remain unchanged. When performed by expert liver and laparoscopic surgeons in selected patients and tumors, laparoscopic resection of benign liver tumor is a promising technique.

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Section: Introductionmentioning

confidence: 99%

Laparoscopic liver resection of benign liver tumors

et al. 2003

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“…Hinsichtlich des onkologischen Outcomes liegen jedoch bereits Überlebens-daten vor,welche die laparoskopische Tumornephrektomie als onkologisch sicheres Verfahren ausweisen [6,10,13] Portis et al [15] berichten über 5-Jahres-Überle-bensraten nach laparoskopischer Tumornephrektomie und konnten gegenüber einer Vergleichsgruppe nach offener Tumornephrektomie identische Überlebens-raten beobachten. In unserem eigenen Krankengut konnten wir bei 61 Patienten, die einen lokal begrenzten Tumor aufwiesen in einem Nachbeobachtungszeitraum bis zu 30 Monaten in zwei Fällen einen Progress feststellen.In beiden Fällen handelte es sich um lokal fortgeschrittene, schlecht differenzierte Tumoren mit einem hohen Metastasierungsrisiko.…”

Section: Diskussionunclassified

Die laparoskopische transperitoneale Tumornephrektomie: Indikation, Technik und onkologisches Outcome

et al. 2003

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Renal cell carcinoma is likely to become one of the most important indications for laparoscopic surgery worldwide. The laparoscopic technique combines the benefits of the minimally invasive approach with established surgical principles. In our institution the laparoscopic transperitoneal approach with intact specimen extraction has become the standard technique for radical nephrectomies. We report the indications, techniques, and oncological outcome in a single center experience in 100 cases. The mean tumor size was 5.9 cm (range: 2-11 cm), the blood loss was 220 ml, and the mean surgical time was 211 min, including the learning curves of five surgeons. Histological findings were pT1 in 66 (66%), pT2 in 11 (11%), and pT3 in 19 (19%) patients with an increasing tumor size according to the experience of the surgeons. In four cases (4%) histology did not prove malignant disease. Positive lymph nodes were detected in three cases (3%) and surgical margins were negative for tumor in all patients. To date 61 patients were available for follow-up; patients with primary metastatic disease were excluded from this analysis. Follow-up was between 1 and 30 months with an average of 12.9 months. Progressive disease occurred in two cases in patients with pT3G3 tumors. No cases of local recurrence or port metastasis occurred during observation. Laparoscopic radical nephrectomy is a routine, effective treatment for patients with renal cell carcinoma. Our follow-up data up to 30 months confirm the effectiveness of laparoscopic radical nephrectomy in terms of surgical principles and oncological outcome.

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“…Deshalb ist die laparoskopische Tumornephrektomie ein onkologisch unproblematischer Eingriff. Alle bisher publizierten Daten bestätigen das [1,2,5,7,8,9,11,14,17]. Deshalb kann nicht überraschen, dass die Akzeptanz der laparoskopischen Tumornephrektomie in letzter Zeit stark zugenommen hat.…”

Section: Zusammenfassungunclassified

“…Dabei sind die Daten von insgesamt 552 Patienten erfasst. Auffallend sind die langen Operationszeiten von Clayman, Ono und Kavoussi [7,9,17]. Diese liegen bei 4-5,5 h. Ono führt allerdings zusätzlich zur Tumornephrektomie auch eine Lymphadenektomie durch.…”

Section: Perioperative Datenunclassified

Laparoskopische Tumornephrektomie

Janetschek

al-Zachrani²,

Vrabec³

et al. 2002

Urologe [A]

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Initially, laparoscopic surgery in urology was restricted to the treatment of benign diseases, whereas its role in the management of malignant disease was restricted to purely diagnostic procedures. Only recently has laparoscopy been introduced for the treatment of low stage renal cell carcinoma (RCC), and the data on both surgical efficiency and oncologic efficacy are very promising. Therefore, we present our experience with laparoscopic radical nephrectomy and data from literature. The technique of the transperitoneal approach is described in detail. Retroperitoneoscopy is a good alternative, however. Intact removal of the specimen within an organ bag to avoid tumor spillage is an important detail of our technique. Our experience amounts to radical nephrectomy in 121 patients. The indication was clinical stage T1-T2. Mean operative time and blood loss was 2.4 h and 154 ml, respectively. The rate of minor or major complications was 5% and 4%, respectively. There was no conversion to open surgery in any patient. Mean postoperative hospital stay was 6.1 days. Data on tumor control are available for 73 patients with a mean follow-up of 13.3 months. There was no recurrence within this period. Radical nephrectomy for low-stage RCC is associated with low morbidity and great surgical efficiency. The rates for local recurrences and metastases are low, tumor-specific survival is high. However, there is still a lack of long-term data on large series of patients. Despite this fact, laparoscopy is already widely accepted for this indication, and it is quite likely that it will become the standard treatment.

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Laparoscopic Versus Open Radical Nephrectomy: A 9-Year Experience

Cited by 119 publications

References 18 publications

Laparoscopic liver resection of benign liver tumors

Laparoscopic liver resection of benign liver tumors

Die laparoskopische transperitoneale Tumornephrektomie: Indikation, Technik und onkologisches Outcome

Laparoskopische Tumornephrektomie

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