[Results of open and laparoscopic partial nephrectomy for localized renal cancer].
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To compare the results of laparoscopic and open partial nephrectomy.From February 2000 to June 2016, 178 patients (mean age 58.2 years) with stage T1 kidney tumors underwent partial nephrectomy. This cohort included 106 (59.5%) men and 72 (40.5%) women. Open partial nephrectomy was performed in 102 (57.3%) patients (group 1) and laparoscopic partial nephrectomy (LPL) - 76 (42.7%, 2nd group). The majority (92.2%) of patients underwent resection for elective and 14 (7.8%) for absolute indications. Preoperatively, 163 (91.6%) and 15 (8.4%) patients had stage T1a stage T1b, respectively. The tumor size ranged from 2.4 to 6.2 cm and from 2 cm to 5.4 cm in group 1 and 2, respectively. A comparative analysis included operative time, warm ischemia time, blood loss, duration of drainage and the length of hospital stay.Open partial nephrectomy was associated with shorter operative time (105 min versus 125 min) and warm ischemia time (14.5 vs. 20.8 min) compared with laparoscopic partial nephrectomy. Laparoscopic partial nephrectomy was characterized by a smaller blood loss (180 ml vs. 365 ml, p<0.05) and a shorter length of hospital stay (2.5 days vs. 5.6 days, p<0.05). One patient from each group was found to have positive surgical margins.Currently, laparoscopic partial nephrectomy is the method of choice for stage T1 kidney tumors. Despite the comparatively longer operative time and warm ischemia time, laparoscopic partial nephrectomy leads to faster patient recovery and fewer complications.Cite
Objective To investigate the clinical efficacy of laparoscopic nephrectomy. Methods The clinical data of 10 cases with laparoscopic nephrectomy in our hospital from March 2011 to February 2012 were retrospectively analyzed. Results The surgery of 9 cases were successful, 1 case with adhesion after renal abscess drainage was diverted to traditional open surgery. The operative time was 90-145min, average of 100 min; the blood loss was 30-300 ml, average of 95 ml; there was no blood transfusion in and after surgery, no significant complications. The hospital stay was 4-9 days, average of 6.5 days. 1 case of kidney cancer patient was followed up for two years without recurrence. The remaining patients were followed up for 3-12 months, including 2 cases of wound pain, numbness, the symptoms disappeared after six months. 1 cases of renal tuberculosis patients had no recurrence after anti-TB treatment. Conclusion Laparoscopic nephrectomy has many advantages such as less blood loss, fewer complications, faster postoperative recovery, and it is worthy of clinical application.
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Objective: To evaluate laparoscopic nephrectomy at the grassroots level in hospitals on the application. Methods: The hospital from March 2008 to January 2010, 35 patients with retroperitoneal laparoscopic nephrectomy way with simple statistics. The 35 cases of surgical procedures, operative time, blood loss, postoperative complications and length of stay data were analyzed retrospectively. Results: The success of 34 cases, 1 was converted to open operation. Operative time was 65 - 240 min, blood loss 30 - 110 ml, postoperative hospital stay was 3 - 6 days, after bed time, 20 - 30 hours, 3 patients had subcutaneous emphysema, go away. Wound infection did not occur, and no serious complications. Conclusion: The laparoscopic nephrectomy with small incision, less trauma and shorter hospital stay and quicker recovery advantages in primary hospitals.
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[Objective] To evaluate the feasibility and clinical efficacy of Hand-assisted Laparoscopic radical nephrectomy(HALRN). [Methods] 36 patients with renal cell carcinoma received Hand-assisted Laparoscopic radical nephrectomy. [Results] All 36 patients were performed with Hand-assisted Laparoscopy successfully, the operation time ranged from 65 to 220 mins, average time being 105 mins; the blood loss during operations was 20 to 200 mL, average blood loss being 85 mL; the hospital stay was 5 to 11 days. [Conclusions] Hand-assisted Laparoscopic radical nephrectomy not only has the advantages of micro-invasiveless, less blood loss, short time recover to normal as in Pure Laparoscopic Surgery, but also has the advantages of safe, short operation time as in traditional open operation, is a new alternative surgical technique for radical nephrectomy.
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Objective: To compare the effect of two surgical methods for bilateral inguinal hernia.Method: The patients were randomly divided into group A and B,group A for the laparoscopic group(n=48),group B for the single-incision surgery(n=39).Compared two groups of the surgical time,blood loss and postoperative recovery,including postoperative recovery time,postoperative complications,and postoperative swelling,wound infection,hematoma,incisional hernia,ischemic orchitis after surgery relapse rate.Result:Operative time,blood loss,incision length differences were statistically significant between two groups(P 0.05),while no significant differences in postoperative complications(P 0.05).Conclusion: The laparoscopic treatment for bilateral inguinal hernia in the operative time,operative bleeding was significantly better than traditional suprapubic single incision,without increasing postoperative complications.
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Objective To evaluate the clinical differences of surgery indications, complications and recovery in uterine myomectomy through laparoscopy,laparoscopic assisted vaginal myomectomy and laparoscopic assisted minilaparotomy.Methods 154 women undergoing laparoscopic uterine myomectomy,13 women undergoing laparoscopic assisted vaginal myomectomy and 19 women undergoing laparoscopic assisted minilaparotomy enrolled in the study from April 2005 through August 2007 and were analyzed retrospectively. Results The unspecified infections or febrile episodes occurred in 5 cases, the median operation time was(47.3±25.2)min and the median blood loss was(84.3±34.6)ml in the group of laparoscopy. The unspecified infections or febrile episodes occurred in 4 cases, the median operation time was(78.6 ±42.9)min and the median blood loss was(131.4±52.6)ml in the group of laparoscopic assisted vaginal myomectomy. The unspecified infections or febrile episodes occurred in 1 cases, the median operation time was(72.4±47.5)min and the median blood loss was(130.6±58.7)ml in the group of laparoscopic assisted minilaparotomy.Conclusion Comparing three approaches to myomectomy, each has different indication because of different surgery techniques. The benefits of laparoscopy are lower intraoperative blood loss, speedier return to normal activities and fewer unspecified infections or febrile episodes.
Uterine myomectomy
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Objective To analyze clinical value of retroperitoneal laparoscopic nephrectomy.Methods Clinical data of 34 patients with retroperitoneal laparoscopic nephrectomy were analyzed.Results 34 cases were operated successfully.The average operation time was 125 min,average blood loss was 80ml.The average hospital stay was 7 days after surgery.The intraoperative and postoperative complications were not serious.Conclusion Laparoscopic nephrectomy has less trauma and fast recovery and is safe and reliable.
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Objective To evaluate and compare the therapeutic efficacy of PFN fixation and hemiarthroplasty in the treatment of elderly patients with intertrochanteric fracture.Methods 66 patients were divided into PFN fixation group(group A) and the hemiarthroplasty group(group B) and conventional surgical approach were adopted in both groups.Surgical time,blood loss,hospital costs,weight-bearing ambulation after surgery,hip function and complications were observed.Results Surgical treatment was successful in all the 66 cases of intertrochanteric fractures patients.There was no significant difference of complication between the two groups(P 0.05).There were significantly less operative time,more blood loss and hospital costs in group B,and time before weight-bearing ambulation after surgery was significantly shorter in group B(all P 0.01).Postoperative Harris hip score of group B was better than that of group A(P 0.05).Conclusion Two surgical procedures are effective to some degree,and strict control of surgical indications,contraindications and operating skills is critical.
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Intertrochanteric fracture
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Objective: To evaluate the clinical efficacy of transperitoneal laparoscopic ureterovesical reimplantation.Methods: Three patients who were diagnosed with simple congenital ureter outlet stricture,underwent transperitoneal laparoscopic ureterovesical reimplantation.Results: All the operations were successful.The intraoperative blood loss was 20-80 mL(mean 45 mL).And the postoperative hospitalization was 7-12 day.No complications were occurred during operation and the follow up period for 3-6 months in 3 cases.Conclusion: Transperitoneal laparoscopic ureterovesical reimplantation has the advantages of minimal invasion,less blood loss and rapid postoperative rehabilitation,which is an effective and practical procedure.
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To assess the benefits of laparoscopic nephrectomy in children as compared to open surgery and to ascertain whether or not the retroperitoneal technique offers any surgical advantage over the transperitoneal approach.This study gathered retrospective data on a consecutive series of 51 paediatric patients comparing; operative time, length of hospital stay and analgesic requirement. Results show that when laparoscopic surgery is compared with the open technique it took 25 mins longer to perform, there was a shorter post operative stay by 2.5 days, and a 50% reduction in morphine use. Patients who had the retroperitoneal technique were discharged from hospital within one day.Compared to previous studies, the findings in this study suggest that there are distinct benefits in laparoscopy for children. There is some evidence in favour of the retroperitoneal technique. Patients are in hospital for shorter periods and need less analgesia.
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