• 作者：Alfredo Aguilera ; ^{aaguilera11@yahoo.es} ; Manuel Pé ; rez-Utrilla ; Manuel Giron ; Ramó ; n Cansino ; Ana Gil ; Javier de la Peñ ; a
• 关键词：Nefroureterectomí ; a ; Laparoscopia ; Linfadenectomí ; a ; Retroperitoneal
• 刊名：Actas Urol贸gicas Espa帽olas
• 出版年：2009
• 期刊代码：pca37_02104806
• 类别：med
• 出版时间：November-December 2009
• 卷：33
• 期：10
• 页码：1078-1082
• 文件大小：211 K

Purpose

Advances in urological laparoscopy have increased the oncological safety of this approach for managing upper urinary tract tumours, although the open surgical route remains the method of choice. We present our experience with the laparoscopic approach over the past four years and compare it to open surgery.

Materials and methods

Between 1995 and 2009 a total of 95 nephroureterectomies were carried out for tumours: 70 by open surgery and 25 by laparoscopy. Lumbotomy with endoscopic detachment of the ureter was the most common approach in open surgery, while transperitoneal access was used for laparoscopy in all cases, with laparoscopic bladder cuff resection in most patients (56%).

Results

Mean procedure time for the open nephroureterectomies was 205 (130-300) min, with a mean blood loss of 525 (100-1,800) ml and 17 (24.2%) transfusions. The mean hospital stay was 8.4 (3-30) days. Mean procedure time for the laparoscopic nephroureterectomies was 189 (120-270) min, with a mean blood loss of 130 (100-400) ml and 4 (16%) transfusions. The mean hospital stay was 4.5 (2-28) days.

Conclusions

The patients who underwent the laparoscopic procedure had a lower transfusion rate and shorter hospital stay. Oncological control was similar for both approaches, although a longer follow-up and a larger series of cases are still needed for the laparoscopic approach.