• 作者：P. Ló ; pez Cubillana ; A. Prieto Gonzá ; lez ; ^{antonioprietogonzalez@hotmail.com} ; J.I. Tornero Ruiz ; A.I. Ló ; pez Ló ; pez ; E. Cao Avellaneda ; G. Server Pastor ; J.F. Escudero ; P.A. Ló ; pez Gonzá ; lez ; G. Doñ ; ate ; J.C. Ruiz Morcillo ; G. Gó ; mez Gó ; mez ; M. Pé ; rez Albacete
• 关键词：Nefrectomí ; a ; Tumor renal ; Laparoscopia asistida por la mano
• 刊名：Actas Urol贸gicas Espa帽olas
• 出版年：2010
• 期刊代码：pca37_02104806
• 类别：med
• 出版时间：February 2010
• 卷：34
• 期：2
• 页码：186-188
• 文件大小：88 K

Objective

To assess the outcome of hand-assisted laparoscopic nephrectomy in patients with significant complicating clinical factors.

Methods

A retrospective assessment was made of 100 laparoscopic nephrectomies performed at a single hospital from 2001 to 2005. Patients with a history of prior abdominal surgery, prior procedures on the involved kidney, evidence of perirenal inflammation, renal lesions 10 cm or more in diameter, or level I renal vein thrombosis were enrolled.

Results

Twelve patients were enrolled. Of these, 5 had a lesion at least 10 cm in diameter, 2 had renal vein thrombosis, and 5 reported major abdominal surgery. Most patients had more than one of these findings. Three patients showed inflammatory conditions (staghorn calculi) and a T4 renal tumor was successfully treated without conversion to open surgery. Mean operating time and blood loss were 210 minutes and 310 ml respectively, while mean length of hospital stay was 3 days. No patient required conversion to open surgery.

Conclusions

Hand-assisted laparoscopic nephrectomy is an attractive minimally invasive option for technically challenging tumors and has reasonable operating times, blood losses, and complication rates.