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Laparoscopic partial nephrectomy for renal tumours: early experience in Singapore general hospital.

Title: Laparoscopic partial nephrectomy for renal tumours: early experience in Singapore general hospital.
Authors: Nor Azhari MZ; Department of Urology, Singapore General Hospital, Singapore.; Tan YH; Sunga PA; Yip SK; Cheng CW
Source: Annals of the Academy of Medicine, Singapore [Ann Acad Med Singap] 2009 Jul; Vol. 38 (7), pp. 576-5.
Publication Type: Journal Article; Research Support, Non-U.S. Gov't
Language: English
Journal Info: Publisher: Academy Of Medicine, Singapore Country of Publication: Singapore NLM ID: 7503289 Publication Model: Print Cited Medium: Internet ISSN: 2972-4066 (Electronic) Linking ISSN: 03044602 NLM ISO Abbreviation: Ann Acad Med Singap Subsets: MEDLINE
Imprint Name(s): Publication: Singapore : Academy Of Medicine, Singapore; Original Publication: Singapore.
MeSH Terms: Carcinoma, Renal Cell/*surgery ; Kidney Neoplasms/*surgery ; Laparoscopy/*methods ; Nephrectomy/*methods; Adult ; Aged ; Female ; Hospitals, General ; Humans ; Length of Stay ; Male ; Middle Aged ; Retrospective Studies ; Singapore
Abstract: Introduction: To review the perioperative and short-term outcome of all laparoscopic partial nephrectomies (LPN) performed in a single institution.; Materials and Methods: Thirteen consecutive patients who underwent LPN since the beginning of the programme in March 2002 to January 2008 were enrolled. Demographic, perioperative and follow-up data were retrospectively collected. Transperitoneal approach was used in all cases, and vascular control was achieved with the use of a laparoscopic Satinsky clamp or vascular tape. The tumour was excised using cold scissors. Transected intrarenal vessels were suture ligated and the parenchymal defect was closed primarily with absorbable suture over a bolster.; Results: Thirteen patients underwent a total of 14 LPN. The median age of patients was 60 years (range, 41 to 77). The mean tumour size was 24 +/- 11.4 (2SD) mm. The mean operative time was 228 +/- 129 (2SD) minutes and median warm ischaemia time was 35 minutes (range, 24 to 68). Postoperatively, serum haemoglobin level decreased by a mean of 1.4 +/- 2.5 (2SD) gm/dL and serum creatinine increased by a mean of 22.5 +/- 25.8 (2SD) micromol/L. Twelve out of 13 (92%) patients achieved their baseline serum creatinine level within 1 month postoperatively. There was 1 open conversion (7%), and 2 patients (14%) required blood transfusion perioperatively. Two patients (14%) had transient fever postoperatively due to basal atelectasis. No other complications were encountered. Median patient hospital stay was 4 days (range, 2 to 10). Eleven out of 14 (79%) of the tumours were renal cell carcinoma (RCC). At a median follow-up of 12 months (range, 6 to 53), all except 1 patient with RCC were disease-free.; Conclusions: Our experience has shown that laparoscopic partial nephrectomy is a safe, feasible technique in our centre for patients with small exophytic renal tumours. Patients can be discharged early with preservation of renal function and good early cancer control.
Entry Date(s): Date Created: 20090805 Date Completed: 20091016 Latest Revision: 20200825
Update Code: 20260130
PMID: 19652847
Database: MEDLINE

Journal Article; Research Support, Non-U.S. Gov't