Renal and Adrenal Minilaparoscopy: A Prospective Multicentric Study

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• 作者：Alberto Breda^a ; ^{albbred@hotmail.com" class="auth_mail" title="E-mail the corresponding author} ; Pietro Castellan^a ; Rui Azevedo Freitas^a ; Ivan Schwartzmann^a ; Jesus Luis Á ; lvarez Osorio^b ; Josè ; Heriberto Amó ; n-Sesmero^c ; Josè ; Antonio Bellido^d ; Enrique Ramos^e ; Diego Rengifo^f ; Juan Antonio Peñ ; a^a ; Humberto Villavicencio^a
• 刊名：Urology
• 出版年：2016
• 出版时间：June 2016
• 年：2016
• 卷：92
• 期：Complete
• 页码：44-50
• 全文大小：166 K

文摘

To investigate the role of contemporary minilaparoscopy (ML; 3 mm instruments and laparoscope) and to identify predictive factors for complications in a prospective multicenter series for renal and adrenal surgeries.

Materials and Methods

From July 2013 to December 2014, 110 patients from 6 laparoscopic Spanish centers were enrolled. A common database was used and data were collected in a prospective manner. Standard approach was defined as 3 to 4 3-mm trocars with a 3-mm laparoscope and 3-mm instruments (Karl Storz, Tuttlingen, Germany). Descriptive variables were analyzed and statistical analysis was performed for predictive factors for complications.

Results

Patient mean age was 57.8 ± 14.6 years, with an average body mass index of 25.3 ± 3.6 kg/m². Median American Society of Anesthesiologists score was II and 32% (n = 35) of the patients had a previous surgery. A total of 59 nephrectomies, 20 partial nephrectomies, 9 nephroureterectomies, 13 pyeloplasties, 3 pyelolithotomies, and 6 adrenalectomies were performed. Overall operative time was 180 ± 64 minutes. There were 12 clampless partials and 8 with a mean warm ischemia time of 14 ± 7 min. There were 5% of intraoperative and 8% of postoperative complications (Clavien II-IV). Mean hospital stay was 5 ± 2.3 days, with optimal pain and cosmetic control.

Conclusion

To our knowledge, this is one of the largest prospective series of ML for renal and adrenal surgeries. Despite a mean operative time possibly longer than in standard laparoscopy, clinical and safety outcomes are not compromised. Furthermore, ML results in excellent pain control and cosmetic outcomes.