Laparoscopic Radical Nefrectomy for the Surgical Treatment of the Kidney Tumors

Abstract

Introduction: The laparoscopic radical nephrectomy is evolving as the standard of care in the treatment of kidney tumors. A retrospective analysis of the laparoscopic radical nephrectomies performed for the treatment of kidney tumors is presented here. Materials and Methods: 18 patients underwent laparoscopic radical nephrectomy operation between March 2004 and January 2007 in our department. T Transperitoneal approach was utilized in 9 of the cases, while the rest were performed retroperitoneally. 3 of the transperitoneal cases were performed hand-assisted. Results: The mean age of the patients was 58 +/- 13 (35-80). 9 of the cases were performed on the left side and the rest were carried out on the right. The average tumor size was 128 +/- 24 (80-165) mm. The mean tumor size was 63 +/- 18 mm and 47 +/- 12 mm in transperitoneal and retroperitoneal approaches, respectively. All the cases were done through an average of 4 +/- 1 ports ranging from 5 to 12 mm in size. The average length of the operations was 184 +/- 53 min. Specimens were removed through a right or left lower abdominal incision. All of the patients were mobilized in the first 24 hours following surgery. The mean hospital stay was 3.7 +/- 0.8 days. One of the patients required blood transfusion secondary to bleeding during surgery. None of the patients experienced any major complications. Conclusion: Laparoscopic radical nephrectomy is a safe operation in patients with kidney tumors. Although, transperitoneal approach is the procedure of choice for tumors greater than 6-7 cm in our department, larger tumors have been started to be removed via retroperitoneal approach secondary to increasing experience in the latter procedure. The procedure of choice should depend on the experience and choice of the individual surgeon.