Result of En Bloc Renal Hilar Ligation during Laparoscopic Radical Nephrectomy and Laparoscopic Radical Nephroureterectomy
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Abstract
Background: En bloc renal hilar ligation has historically been associated with very rare complicationof renal arteriovenous fistula (AVF). Most urologists dissect out renal artery and vein separately to avoid this complication but the procedure increases the operative time and risk of vascular injury.
Objective: To study result of En bloc renal hilar ligation during laparoscopic radical nephrectomy (LRN) and laparoscopic radical nephroureterectomy (LRNU).
Material and method: A retrospective review was performed in consecutive 80 patients at 1, 6, 12, 24, 36, 48 and 60 months follow-up. The subjects were patients underwent LRN and LRNU, en bloc renal hilar ligation technique, between June 2007 and June 2012 by one surgeon.
Results: Mean age of the patients was 60.19 years. Indications for surgery were renal cell carcinoma (65%), transitional cell carcinoma (20%) and others (15%). There was no complication related to this technique, particularly AVF, at the mean follow-up of 39.51 months.
Conclusions: This study showed no evidence of AVF. En bloc renal hilar ligation is safe and effective. This technique can be utilized in noninflammatory renal diseases without potential vascular injury.
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References
Clayman RV, Kavoussi LR, Soper NJ, Dierks SM, Meretyk S, Darcy MD, et al. Laparoscopic nephrectomy: initial case report. J Urol. 1991;146:278.
Copcoat M, Joyce A, Rassweiler J, Popert R. Laparoscopic nephrectomy the Kings clinical experience. J Urol. 1992;147:433A.
Kerbl K, Clayman RV, McDougall EM, Kavoussi LR. Laparoscopic nephrectomy the Washington university experience. Br J Urol. 1994;73:231.
Higashihara E, Tanaka T, Nutahara K, Aso Y. Laparoscopic adrenalectomy: technical review. Jap J Endourol. 1992;5:150.
Matsuda T, Terachi T, Yoshida O. Laparoscopic adrenalectomy: the surgical technique and initial results of 13 cases. Min.Invasive Ther. 1993;2:123.
Elspeth M, McDougall EM, Clayman RV, Osama ME. Laparoscopic radical nephrectomy for renal tumor the Washington university experience. J Urol. 1996;155:1180-5.
Clayman RV, Kavoussi LR, McDougall EM, Soper NJ, Fingenshau RS, Chandhoke PS, et al. Laparoscopic nephrectomy a review of 16 cases. Surg Laparosc Endosc. 1992;2:29.
Permpongkosol S, Chan DY, Link RE, Sroka M, Varkarakis I, Lima G, et al. Long-term survival analysis after laparoscopic radical nephrectomy. J Urol. 2005;174:1222-5.
Hollingsworth JM, Miller DC, Dunn RL, Montgomery JS, Wolf JS Jr. Cost trends for oncological renal Surgery: support for a laparoscopic standard of care. J Urol. 2006;176:1097-101.
Fenn NJ, Gill IS. The expanding indications for laparoscopic radical nephrectomy. BJU Int. 2004;94:761-5.
Rapp DE, Orvieto MA, Gerber GS, Johnston WK 3rd, Wolf JS Jr, Shalhav AL. En bloc stapling of renal hilum during laparoscopic nephrectomy and nephroureterectomy. Urology. 2004;64:655-9.
Hollingsowrth KW. Arteriovenous fistula of the renal vessels. Am J Med Sci. 1934;188:399.
Lasher EP, Glen F.Effects on kidney and blood pressure of artificial communication between renal artery and vein. Arch Surg. 1939;38:886.
Muller WH, Goodwin WE. Renal arteriovenous fistula following nephrectomy. Ann Surg. 1956;144:240.
Gitlitz GF, Fell SC, Sagerman RH, Hurwitt ES. Postnephrectomy arteriovenous fistula: case report and review of literature. Ann Surg. 1963;157:511.
Shida T, Gan K, Shio K,Takemura Y. A case of postnephrectomy arteriovenous fistula. Jpn J Surg. 1989;19:738-9.
Shigeru A, Kenkichi M, Miyanohara H, Nakamura K, Arima T, Morishita Y, et al. Postnephrectomy arteriovenous fistula. Int Med. 1992;31:27-30.
Lacombe M. Renal arteriovenous fistula following nephrectomy. Urology. 1985;25:13-6.
Sharp WV, Belden TA, King PH, Teague PC. Suture resistance to infection. Surgery. 1982;91:61-3.
Scheidbach H, Tannapfel A, Schmidt U, Lippert H, Kockerling F. Influence of titanium coating on the biocompatibility of a heavyweight polypropylene mesh an animal experimental model. Eur Surg Res. 2004;36:313-7.
Kouba E, Smith AM, Derksen JE, Gunn K, Wallen E, Pruthi RS. Efficacy and safety of en bloc ligation of renal hilum during laparoscopic nephrectomy. Urology. 2007;69:226-9.
Jae HC, Joo YL, Wan L, Ki SL, Tae HK, Seung WL. Efficacy and safety of En bloc stapling of renal hilum during laparoscopic radical nephrectomy prospective randomized controlled trial. J Urol. 2012; 187: e581-2.
Ryback J, Latchamsetty K, Hoeksema J, Coogan C. Routineen bloc stapling of the renal hilum during laparoscopic nephrectomy is safe and effective. J Urol. 2013;189:e340.