The Application of 'Renal Pedicle Rotation' Method in Retroperitoneal Laparoscopic Partial Nephrectomy for Renal Ventral Tumors

摘要

Objectives: To present preliminary experience of renal pedicle rotation method in retroperitoneal laparoscopic partial nephrectomy (RLPN) for renal ventral tumors. Methods: A retrospective analysis of renal surgery database about patients undergoing RLPN was conducted. We identified 14 consecutive cases of all the surgeries from December 2013 to October 2014 with renal ventral tumors. The 14 surgeries were all in the application of renal pedicle rotation method, an intraoperative skill in which surgeons rotates the kidney on renal pedicle axis after separating renal artery and vein for a better tumor exposure. Results: A total of 14 patients underwent RLPN. All surgeries were successful without conversion to radical nephrectomy or open partial nephrectomy. The mean operative time was 171.147.2min (range 83-246), the mean warm ischemia time was 15.9 +/- 9.8min (range 7-35) and the mean estimated blood loss was 89.3 +/- 102.2mL (range 10-300). Mean postoperative hospital stay was 6.2 +/- 1.9 days (range 4-10) and mean retroperitoneal drainage was 4.2 +/- 1.4 days (range 2-8). No intraoperative complications occurred. Postoperative complications developed in four patients. All patients had negative margins and pathological examination revealed 10 (71.4%) clear cell carcinomas, two (14.2%) epithelial renal angiomyolipoma, one (7.1%) papillary carcinoma and one (7.1%) nephrotuberculosis. The review of the early oncologic outcomes revealed no local recurrence and distant metastasis. Conclusion: The renal pedicle rotation method might be a feasible and safe procedure to get a better tumor exposure for incision and suture in renal ventral tumors RLPN surgeries with acceptable postoperative outcomes.