Laparoscopic radical nephrectomy

OBJECTIVE: Evaluation of retrospective results of treatment of patients with kidney cancer, who have undergone a laparoscopic or a retroperitoneoscopic radical nephrectomy.

RESULTS: Only one of the patients suffered a fatal outcome. 12 patients (6.5%) had a conversion. The duration of operation ranged between 50-215 minutes (average of 104.3 minutes), time of insufflation ranged between 36-205 minutes (average of 96.2 minutes). Average intraoperative blood loss constituted 147.8 ml. Patients spent 2-18 days (average 4.1 days) in the hospital after the surgery.

MATERIALS AND METHODS: We have conducted a retrospective analysis of 185 patients with kidney tumour, who have undergone a laparoscopic or a retroperitoneoscopic radical nephrectomy during 2010-2015. Amongst the participants there were 116 men (62.7%) and 69 women (37.3%) aged 29-86 (average age of 58.1 years). 150 patients (81.1%) have performed radical nephrectomy by transperitoneal access, while 30 patients (16.2%) experienced identical process through retroperitoneal access. 5 cases (2.7%) hybrid technique was utilized. 97 patients performed nephrectomy on the right side, 88 patients on the left side. 178 patients (96.2%) had a single kidney tumours, while 7 (3.8%) had multiple tumours ranging between 2-8. 15 patients, who experienced a laparoscopic radical nephrectomy, had a thrombus in kidney vein (level 1 under Mayo classification). 1 patient had a thrombus in vena cava (level 2).

CONCLUSION: There is an obvious advantage to utilizing a laparoscopic or a retroperitoneoscopic intervention in order to treat kidney cancer. The process constitutes minimal invasiveness, low death rates, minimal intraoperative blood loss and fast rehabilitation of the patients. 72% of patients who have who have experienced surgical intervention, such as radical nephrectomy, spent only 3-4 days in the hospital.