Retroperitoneoscopic Versus Open Surgical Radical Nephrectomy for Large Renal Cell Carcinoma in Clinical Stage cT2 or cT3a: Quality of Life, Pain and Reconvalescence

Dillenburg, Wolfgang; Poulakis, Vassilis; Skriapas, Konstantinos; Vries, Rachelle de; Ferakis, Nikolaos; Witzsch, U.; Melekos, Michael D.; Becht, E.

doi:10.1016/j.eururo.2005.10.021

Cited by 55 publications

(43 citation statements)

References 32 publications

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“…Several studies confirmed that laparoscopic and hand-assisted nephrectomies produce less pain compared with an open operation [5–9]. Nonetheless, some patients undergoing laparoscopic live donor nephrectomy still suffer significant postoperative pain, to the point where they require parenteral opioids.…”

Section: Pain After Lldnmentioning

confidence: 99%

Pain Management in Laparoscopic Donor Nephrectomy: A Review

Thiyagarajan

Bagul

Nicholson

2012

Pain Research and Treatment

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The management of postoperative pain is a key to patient early recovery, in particular, where the surgery was performed to benefit another human being. In recent years it has been recognized that multimodal analgesic methods are superior for postoperative pain relief. It is also imperative to remember that inadequately managed acute postoperative pain opens the doorway to possible suffering from chronic postoperative pain later. Although the laparoscopic donor nephrectomy has reduced the disincentives associated with open surgery, still significant percentage of donors suffers from postoperative pain. In the UK, patient-controlled analgesic system (PCAS) using morphine for postoperative pain relief is being used in majority of the transplant centres. Though opioids provide good analgesia, they are far from being an ideal analgesic due to their adverse effects. This paper pragmatically looks in depth on different modalities of pain management in patients undergoing laparoscopic live donor nephrectomy.

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Section: Pain After Lldnmentioning

confidence: 99%

Pain Management in Laparoscopic Donor Nephrectomy: A Review

Thiyagarajan

Bagul

Nicholson

2012

Pain Research and Treatment

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“…Care must be exercised when performing this excision for the colon lies immediately medial. A more recent review of 23 retroperitoneoscopic radical nephrectomies for large renal tumors (mean size 8.9 cm) also demonstrated superior results with laparoscopic surgery compared to the open approach, including a 100% negative margin rate, and significantly higher quality of life scores that persisted at 6 and 12 months postoperatively [15 ]. After laparoscopic surgery all convalescence scores returned to baseline by 6 months, but remained significantly worse in the open cases.…”

Section: Laparoscopic Nephrectomy For Stage T2 Renal Cell Carcinomamentioning

confidence: 77%

“…The contrary has been demonstrated where the incision after laparoscopic surgery was approximately half the size of the open incision and the advantages of laparoscopy persisted even for tumors larger than 7 cm [15 ]. In addition, the morbidity of a flank incision and the associated bulge reported in 50% of patients could be avoided [16].…”

Section: Laparoscopic Nephrectomy For Stage T2 Renal Cell Carcinomamentioning

confidence: 95%

Expanding the indications for laparoscopic radical nephrectomy

Mattar

Finelli

2007

Current Opinion in Urology

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“…Chronic pain occurs in approximately 20–26% of cases undergoing open nephrectomy; highlighting that current methods which are being used for postoperative pain management following nephrectomy are inadequate. [2223]…”

Section: Discussionmentioning

confidence: 99%

Comparative evaluation of continuous thoracic paravertebral block and thoracic epidural analgesia techniques for post-operative pain relief in patients undergoing open nephrectomy: A prospective, randomized, single-blind study

et al. 2017

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Background:Open surgical procedures are associated with substantial postoperative pain; an alternative method providing adequate pain relief with minimal side effects is very much required.Aim:The aim of this study was a comparative evaluation of the efficacy of continuous thoracic paravertebral block (PVB) and thoracic epidural analgesia (EA) for postoperative pain relief in patients undergoing open nephrectomy.Settings and Design:Prospective, randomized, and single-blind study.Materials and Methods:Sixty adult patients undergoing open nephrectomy under general anesthesia were randomized to receive a continuous thoracic epidural infusion (Group E) or continuous thoracic paravertebral infusion (Group P) with bupivacaine 0.1% with 1 μg/ml fentanyl at 7 ml/h; both infusions were started after induction of anesthesia. The primary outcome measures were postoperative pain during rest (static pain), deep inspiration, coughing, and movement (getting up from supine to sitting position); the secondary outcome measures were postoperative nausea and vomiting, requirement of rescue antiemetic, hypotension, sedation, pruritus, motor block, and respiratory depression. These were assessed till the morning of the third postoperative day.Statistical Analysis:Results were analyzed by the one-way ANOVA, Chi-square test, and Mann–Whitney U-test. P < 0.05 was considered significant.Results:Both the groups were similar with regard to demographic factors (P > 0.05). The visual analog scale scores at rest, deep breathing, coughing and movement, and postoperative fentanyl consumption were similar in the two groups (P > 0.05); the incidence of side effects was also similar in the two groups (P > 0.05).Conclusions:Continuous thoracic PVB is as effective as continuous thoracic EA in providing pain relief in patients undergoing open nephrectomy in the postoperative period. The side effect profile of the two techniques was also similar.

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Retroperitoneoscopic Versus Open Surgical Radical Nephrectomy for Large Renal Cell Carcinoma in Clinical Stage cT2 or cT3a: Quality of Life, Pain and Reconvalescence

Cited by 55 publications

References 32 publications

Pain Management in Laparoscopic Donor Nephrectomy: A Review

Pain Management in Laparoscopic Donor Nephrectomy: A Review

Expanding the indications for laparoscopic radical nephrectomy

Comparative evaluation of continuous thoracic paravertebral block and thoracic epidural analgesia techniques for post-operative pain relief in patients undergoing open nephrectomy: A prospective, randomized, single-blind study

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