Fully perfused laparoscopic partial nephrectomy: surgical technique and outcomes

Authors

  • Satit Siriboonrid Division of Urology, Department of Surgery, Phramongkutklao Hospital, Bangkok, Thailand
  • Nattapong Binsri Division of Urology, Department of Surgery, Phramongkutklao Hospital, Bangkok, Thailand
  • Sarayuth Karnchanatarayont Division of Urology, Department of Surgery, Phramongkutklao Hospital, Bangkok, Thailand
  • Poonkiat Reungpoca Division of Urology, Department of Surgery, Phramongkutklao Hospital, Bangkok, Thailand

Keywords:

Full perfusion, partial nephrectomy, laparoscopic surgery

Abstract

Objective:  To present a surgical technique and outcome of fully perfused laparoscopic partial nephrectomy (LPN).

Material and Method:  Fifteen patients underwent fully perfused LPN between January 2014 and January 2018 for renal masses. We studied a subgroup of
patients who underwent fully perfused LPN (non-clamp). Our technique was utilized for exophytic, non-hilar masses that had a diameter of less than 2 cm.
We developed our technique to avoid ischemia reperfusion renal injury while minimizing bleeding.

Results:  We reviewed 15 cases of fully perfused LPN. Utilizing a non-clamp procedure resulted in an average blood loss of 100 ml, 2 days of hospital stay,
and minimal change in serum creatinine.

Conclusion:  Fully perfused LPN is a feasible procedure for the treatment of renal masses. Benefits of this procedure are its minimal invasiveness and prevention
of ischemic reperfusion kidney injury.

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References

Roger CG, Singh A, Blatt AM, Linehan WM, Pinto PA. Robotic partial nephrectomy for complex renal tumors: Surgical technique. Eur Urol 2008;53:514-21.

Godoy G, Ramanathan V, Kanofsky JA, O’Malley RL, Tareen BU, Taneja SS, et al. Effect of warm ischemic time during laparoscopic partial nephrectomy on early postoperative glomerular filtration rate. J Urol 2009;181:2438-43.

Patel AR, Eggener ASE. Warm ischemic less than 30 min is not necessarily safe during partial nephrectomy: Every minute matters. Urol Oncol 2011;29:826-8.

Turna B, Frota R, Kamoi K, Lin YC, Aron M, Desai MM, et al. Risk factor analysis of postoperative complications in laparoscopic partial nephrectomy. J Urol 2008;179:1289-94.

Gill IS, Patil MB, Abreu AL, Ng C, Cai J, Berger A, et al. Zero ischemia anatomical partial nephrectomy: A novel approach. J Urol 2012;187:807-14.

Patil MB, Lee DJ, Gill IS. Eliminating global renal ischemia during partial nephrectomy: An anatomical approach, Curr Opin Urol 2012;22:83-7.

Thompson RH, Lane BR, Lohse CM, Leibovich BC, Fergany A, Frank I, et al. Comparison of warm ischemia versus no ischemia during partial nephrectomy on a solitary kidney. Eur Urol 2010;58:331-6.

Klingler DW, Hemstreet GP, Balaji KC. Feasibility of robotic radical nephrectomy-initial results of single-institution pilot study. Urology 2005;65:1086-9.

Roger CG, Metwalli A, Blatt AM, Bratslavsky G, Menon M, Linehan WM, et al. Robotic partial nephrectomy for renal hilar tumors: A multiinstitutional analysis. J Urol 2008;180:2353-6.

Abaza R, Picard J. A novel technique for laparoscopic or robotic partial nephrectomy: Feasibility study. J Endourol 2008;22:1715-9.

Rais-Bahrami S, George AK, Herati AS, Srinivasan AK, Richstone L, Kavoussi LR. Offclamp versus complete hilar control laparoscopic partial nephrectomy: omparison by clinical stage. BJU Int 2012;109:1376-81.

Tanagho YS, Bhayani SB, Sandhu GS, Vaughn NP, Nepalese KG, Figenshau RS. Renal functional and Perioperative outcomes of off-clamp versus clamped robot-assisted partial nephrectomy: Matched cohort study. Urology 2012;80:838-43.

George AK, Herati AS, Srinivasan AK, Rais-Bahrami S, Waingankar N, Sadek MA, et al. Perioperative outcomes of off-clamp vs complete hilar control laparoscopic partial nephrectomy. BJU Int 2013;111:E235-41.

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Published

2020-12-02

How to Cite

Siriboonrid, S., Binsri, N., Karnchanatarayont, S., & Reungpoca, P. (2020). Fully perfused laparoscopic partial nephrectomy: surgical technique and outcomes. Insight Urology, 41(2), 81–87. Retrieved from https://he02.tci-thaijo.org/index.php/TJU/article/view/247862

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Original article