Nefrectomía parcial laparoscópica: experiencia de 135 casos

Introduccion: La nefrectomia parcial laparoscopica (NPL) es considerada hoy una alternativa terapeutica para el manejo de tumores renales menores de 4 cm. Sus principales ventajas son permitir un excelente control oncologico, ademas de preservar la unidad renal. Por otro lado ha permitido acortar los tiempos de hospitalizacion, disminuir el dolor postquirurgico y lograr menores tiempos de recuperacion en los pacientes. El objetivo del presente estudio es presentar nuestra experiencia en nefrectomias parciales laparoscopicas durante los ultimos 12 anos. Materiales y metodos: Estudio retrospectivo de sometidos a NPL entre los anos 2000 y 2012. En todos los casos la cirugia fue realizada por un mismo cirujano. Se obtuvo informacion demografica de los pacientes, tamano y ubicacion del tumor, via de abordaje, tiempo quirurgico, sangrado intraoperatorio, tiempo de hospitalizacion y complicaciones. El analisis de los datos se llevo a cabo con el programa SPSS v17. Se considero significativo un p Introduction: Laparoscopic partial nephrectomy (LPN) has become the first-line surgical technique for the management of renal tumors smaller than 4 cm. Its main advantages are an excellent oncologic control together with the preservation of nephron units. Moreover it implies a shorter-length of hospital stay, less postoperative pain and shorter recovering times for patients. The aim of this report is to show our experience and compare it with the resuls reported in the international literature. Materials and methods: All patients that underwent LPN within years 2000 and 2010 were retrospectively studied. In all cases surgery was performed by the same surgeon. Data was collected retrospectively, including clinical and histopathologic information, as well as surgical and functional results. Results: One hundred and thirty five were included (70.4 percentmale). Mean age was 56.9 +/- 12.8 years. Eighty-two surgeries were left and 53 right. Regarding to the location of the mass within the kidney, 25.2 percent were found at the upper pole, 46.7 percent in the middle portion, and 28.1percent at the lower pole. In 40 percent of cases the tumor was located in a position described as technically complex. Regarding to the surgical approach, 42.2 percent were performed by transperitoneal and retroperitoneal 57.8 percent for. There were eight conversions to open surgery. The average tumor size was 3.26 +/- 1.6 cm. Mean operative time was 106.2 +/- 38.2 minutes. The median blood loss was 100cc (range