Therapeutic effect of retroperitoneal laparoscopic partial nephrectomy for kidney tumor:a report of 24 cases

Objective To explore the therapeutic effect and clinical value of retroperitoneal laparoscopic partial nephrectomy and open partial nephrectomy on the treatment of kidney tumor.Methods Retroperitoneal laparoscopic partial nephrectomy was performed in 16 cases of renal cell carcinoma and 8 cases of renal hamartoma.Open partial nephrectomy was performed in 13 cases of renal cell carcinoma and 4 cases of renal hamartoma.The operation effects,operation time,blood loss,postoperative analgesic and the length of hospital stay were compared between the two groups.All the patients were followed up for 18 to 36 months,and the recovery of renal function and the rate of tumor recurrence were examined.Results Twenty-three cases of retroperitoneal laparoscopic partial nephrectomy were technically successful(only in one case it was converted to open surgery owing to severe bleeding,indistinct anatomy and dense adhesion around kidney),the mean operation time was 110(60-210) min,the mean ischemic time was 32(15-55) min,the mean blood loss was 100(30-200) ml.The postoperative complications included 1 case of colonic injury,2 cases of hematoma in the surgical field.All the open partial nephrectomy was carried out successfully.Postoperative complications were 1 case of urinary extravasation,1 case of heart failure and 1 case of deep abscess.The mean operation time was 180(120-360) min,the mean blood loss was 250(200-600) ml,the mean ischemic time was 17.5min.All patients recovered after operation,and the hospital stay was 7-10 days,and no tumor recurrence was found during a follow-up period of 18-36 months.The renal function was partially impaired(20%-40%).Conclusion Retroperitoneal laparoscopic partial nephrectomy is a minimally invasive,safe and feasible operative procedure with quick recovery.It is an ideal surgical method for treatment of kidney tumors.