Laparoscopic-assisted partial nephrectomy combined with open procedure for posteromedial renal tumors

Abstract

Objective: To describe the technique of laparoscopic-assisted partial nephrectomy melded with open procedure in resection of postero-medial renal tumors.

Methods: Six patients with postero-medial renal tumors were admitted between July 2008 and March 2009. They included 4 diagnosed renal cell carcinomas and 2 renal angiomyolipomas on preoperative imaging, and their tumors ranged from 2.5-4.3 cm in diameter. They underwent laparoscopic-assisted nephron-sparing surgery combined with a small-incision procedure.

Results: All 6 patients underwent successful resection. The mean operating time was 124 minutes and the average duration of pneumoperitoneum was 25 minutes. The duration of renal arterial blockage ranged from 19-36 minutes, with an average of 23 minutes. The intraoperative hemorrhage volume averaged 160 mL. Postoperative pathology revealed negative margins in all resected specimens. No urinary fistula or secondary hemorrhage occurred postoperatively, and renal function showed no impairment. The patients were followed for 1-8 months. Ultrasonographic or computed tomography examination revealed no recurrence.

Conclusions: The laparoscopic-assisted partial nephrectomy combined with an open procedure is a novel technique for the resection of posterior medial renal tumors. The technique is safe and effective.