Laparoscopic Partial Nephrectomy With Sequential Precise Tumor-specific Segmental Renal Artery Clamping for Multiple Ipsilateral Renal Tumors: A New Treatment Approach and Initial Experience - 01/11/17
, Juntao Jiang, Wei Zhao, Di Cui, Yuan Ruan, Shujie XiaAbstract |
Objective |
To present our surgical approach and initial experience of laparoscopic partial nephrectomy (LPN) with sequential precise tumor-specific segmental renal artery clamping in patients with multiple ipsilateral renal tumors.
Materials and Methods |
Six patients with multiple ipsilateral renal tumors having imperative indications for nephron-sparing surgery underwent LPN with sequential precise tumor-specific segmental renal artery clamping from May 2012 to September 2015. Patient demographics, perioperative variables, renal functions, and postoperative outcomes were reviewed.
Results |
Overall 15 tumors in 6 patients underwent the sequential precise tumor-specific segmental renal artery clamping LPN without conversion to conventional main renal artery clamping, open surgery, or radical nephrectomy. No severe complication occurred. Mean size of the tumors was 2.5 cm (range 1.8-3.5). Mean tumor-related warm ischemia time was 17 min (range 13-22). The affected kidney functions minimally decreased at recent follow-up and restored 3 months later. No positive tumor margin or extrarenal invasion breakthrough renal capsule was observed after pathologic analysis. Over 12 months' follow-up, no local recurrence and distant metastasis were discovered in these cases postoperatively.
Conclusion |
LPN with sequential precise tumor-specific segmental renal artery clamping is a feasible approach for multiple ipsilateral renal tumors. It minimizes intraoperative warm ischemic injury and promotes encouraging postoperative function of the affected kidney.
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| Financial Disclosure: The authors declare that they have no relevant financial interests. |
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| Funding Support: This work was supported by Shanghai Science and Technology Committee (grant 13DZ1940602), Shanghai Hospital Development Center (grant SHDC12014215), and Shanghai Municipal Commission of Health and Family Planning (grant 20134423). |
Vol 108
P. 102-107 - octobre 2017 Retour au numéro
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