Abstract
Purpose: To estimate the efficacy of the laparoscopic radical nephrectomy we analyzed the
clinical data of our series. Patients and Methods: One hundred eighty five patients were enrolled in our laparoscopic radical nephrectomy
program between July, 1992 and July, 2001. Of the 185 patients, 146 had small renal
tumors (smaller than 5 cm in diameter) and 39 had large tumors (equal to or more than,
5 cm in diameter). Under a laparoscope the kidney, adrenal gland, and perirenal fatty
tissue were dissected in an en bloc fashion. In case of taking out a small tumor,
the specimen was fractionated within the sack to avoid an additional skin incision
after entrapping in the laparoscopy sack in the working space. In case of a large
tumor, regional lymph nodes dissection was done and the specimen was taken out intact
in the sack through an enlarged incision. Results: Our laparoscopic procedure was successful in 171 of the 185 cases;
14 patients required open surgery because of bleeding from an injured vessels or treatment
for other injured organs. The mean operative time was 4.7 hours for both small and
large tumors. Estimated blood loss was between 237 and 380 ml on average for small
and large tumors, respectively. Full convalescence was achieved around 3 weeks after
operation in both groups. Only one patient who had large tumor was found to have micrometastasis
in 1 of 5 regional lymph nodes. Recurrences were observed in 4 cases of the small
tumor group and in 2 cases of the large tumor group during 1 to 108 months of follow-up.
Conclusion: Laparoscopic radical nephrectomy is a very useful and safe surgical procedure for
renal cell carcinoma.
Key words
Renal cell carcinoma - radical nephrectomy - lymphadenectomy - laparoscopy
References
