Laparoscopic Partial Nephrectomy In The Solitary Kidney

A patient with a renal tumor in a solitary kidney has an absolute indication for nephron-sparing surgery. Scant data are available in this regard. Gill et al. (65), measuring serum creatinine results in a cohort of eight patients with a solitary kidney who underwent laparoscopic partial nephrectomy for renal tumor, examined the effects of laparoscopic partial nephrectomy on renal function. Analysis of serum creatinine on postoperative day 1 and the repeat serum creatinine value within 30 days showed a mean change of 0.07 mg/dL after 30 days, which was comparable to open surgery.

Bhayani et al. (125) reported laparoscopic partial nephrectomy in four patients with a tumor in a solitary kidney. All four patients had undergone prior contralateral radical nephrectomy for renal cell carcinoma. Mean tumor size was 2.2 cm (range, 1.8-2.8). A transperitoneal approach was employed in all instances. Mean operative time was 4.2 hours, mean warm ischemia time 15 minutes (range, 7-28), mean blood loss 395 mL (range, 100-800), and mean hospital stay three days (range, 2-4). No perioperative complications occurred. Pathology confirmed renal cancer case in 75% of cases, all with negative margins. No evidence of disease had been detected at a mean follow-up of 17 months (range, 3-35). The mean preoperative baseline serum creatinine was 1.5 mg/dL (range, 1.0-1.8). Postoperative return to baseline creatinine required three days in three patients, and longer in one patient (six postoperative weeks). As previously assessed (9), none of the patients presented long-term change in renal function.

0 0

Post a comment