Comparison of laparoscopic and open surgical techniques in kidney pathologies

Abstract

Objective: Herein, we evaluated surgical resultsof open and laparoscopic kidney surgery during last 11 years, in our clinic. Materials and Methods: During 11 years time period, 150 patients underwent kidney surgery. We evaluated patients’ data retrospectively. One hundred and fourty patients who were followed-up regulary with full data enrolled. Out of our study groups, simple nephrectomies, radical nephrectomies and partial nephrectomies were performed by open technique in 80 patients Group 1 and by laparoscopic technique in 60 patients Group 2 . Demograpihic data, co-morbidites, previous operations were recorded as pre-operative data, operation time, estimated blood loss, blood transfusion rate were recorded as operative data, urethral catherization, drainage catheterization and hospital stay were recorded as post operative data. Additionally, pathology reports and complications which was classified according to modified Clavien classifications were recorded. Statistical significant p value was accepted as p

Keywords

• Kidney,laparoscopy,surgical techniques

Böbrek patolojilerinde açık ve laparoskopik cerrahi tecrübelerimizin karşılaştırılması

Abstract

Amaç: Bu çalışmanın amacı, son 11 yıl içerisinde açık ve laparoskopik cerrahi yöntemlerle uyguladığımız böbrek cerrahisi sonuçlarımızı değerlendirmektir. Gereç ve Yöntemler: Kliniğimizde son 11 yıl içerisinde toplam 150 hastaya böbrek cerrahisi uygulandı. Hasta verileri geriye dönük olarak değerlendirildi. Kayıtlarına ulaşılabilen ve düzenli takipleri olan toplam 140 hasta çalışmaya alındı. Çalışmamızda açık cerrahi yöntemle;basit, radikal ve parsiyel nefrektomi yapılan toplam 80 hasta Grup 1 , laparoskopik yöntemle; basit, radikal ve parsiyel böbrek cerrahisi uygulanan 60 hasta Grup 2 mevcuttu. Hastaların operasyon öncesi verileri olarak; demografik verileri, ek hastalıkları, geçirilen operasyonları, operasyon verileri olarak; operasyon süresi, kanama miktarı,operasyon sonrası verileri olarak;sonda,dren ve hastanede kalış süreleri karşılaştırıldı. Ek olarak patoloji sonuçları ve operasyon sonrası komplikasyonlar modifiye Clavien sınıflamasına göre değerlendirildi. İstatistiki anlamlı p değeri p

Keywords

• Böbrek,cerrahi teknikler,laparoskopi

References

1. Teber D, Erdoğru T,Klein J, Frede T, Rassweiler J. Lapa- roskopik radikal nefrektomi. Turkish Journal of Urology 2005; 31: 41-8.
2. Aminsharifi A, Goshtasbi B. Laparoscopic simple nephrec- tomy after previous ipsilateral open versus percutaneous surgery JSLS 2012; 16: 592-6.
3. Eskicorapci SY, Teber D, Schulze M, Ates M, Stock C, Rass- weiler JJ. Laparoscopic radicalnephrectomy: Thenewgold standart surgical treatment for localized renal cell carcino- ma. TSW Urol 2007; 2: 99-110.
4. Akin Y, Ates M, Celik O, Ucar M, Yucel S, Erdogru T. Complications of urologic laparoscopic surgery: a center surgeon’s experience involving 601 procedures including the learning curve. Kaohsiung J Med Sci 2013; 29: 275-9.
5. Abbou CC, Cicco A, Gasman D, et al. Retroperitoneal la- paroscopic versus open radical nephrectomy. J Urol 1999; 161: 1776-80.
6. Permpongkosol S, Chan DY, Link RE, et al. Long-term survival analysis after laparoscopic radical nephrectomy. J Urol 2005; 174: 1222-5.
7. Colombo JR Jr, Haber GP, Jelovsek JE, Lane B, Novick AC, Gill IS. Seven years after laparoscopic radical nephrec- tomy: oncologic and renal functional outcomes. Urology 2008; 71: 1149-54.
8. Dindo D, Demartines N, Clavien PA. Classification of sur- gical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 2004; 240: 205-13.

9. Cookson MS, Chang SS. Radical nephrectomy. In: S.D. Graham, T.E. Keane (7theds) editor: Glenn’s Urologic Sur- gery. Philadelphia: Lippincott Williams &Wilkins, a Wol- ters Kluwer business; 2010. p. 14-23.
10. Rassweiler J, Coptcoat MJ. Laparoscopic surgery of the kidney and adrenal gland. In: Janetschek G, Rassweiler J, Griffith D editor. Laparoscopic Surgery in Urology. New York: Theime Stuttgart; 1996. p. 139-55.
11. MacLennan S, Imamura M, Lapitan MC, et al; UCAN Systematic Review Reference Group; EAU Renal Cancer Guideline Panel. Systematic review of oncological outco- mes following surgical management of localised renal can- cer. Eur Urol 2012; 61: 972-93.
12. Yiğit Akın, Erhan Ateş, Tibet Erdoğru. Böbrek Hücreli Kanser. Nefroloji Forumu 2008; 2: 14-8.
13. Clayman RV, Kavoussi LR, Soper NJ, et al. Laparoscopic nephrectomy: initial case report. J Urol 1991; 146: 278-82.
14. Başok EK, Yıldırım A, Başaran A, Rıfaioğlu M, Tokuç R. Laparoskopik ve açık böbrek cerrahisinde maliyet analizi. Türk Üroloji Dergisi 2007; 34: 100-7.
15. Parsons JK, Jarrett TJ, Chow GK, Kavoussi LR. The effect of previous abdominal surgery on urological laparoscopy. J Urol 2002; 168: 2387-90.
16. Janetschek G.,Marberger M. Laparoscopic surgery in uro- logy. Curr Opin Urol 2000; 10: 351-7.
17. Janetschek G, Jeschke K, Pechel R. Laparoscopic surgery for stage T1 renal cell carcinoma: Radical nephrectomy and wedge resection. Eur Urol 2000; 38: 131-8.
18. Akin Y. Laparoscopic partial nephrectomy is less morbid than open surgery. Niger J Clin Pract 2012; 15: 372.
19. Elsamra S, Pareek G. Complications of laparoscopic renal surgery. Int J Urol 2010; 17: 206-17.
20. Dunn MD, Portis AJ, Shalhav AL, et al. Laparoscopic ver- sus open radical nephrectomy: a 9-year experience. J Urol 2000; 164: 1153-9.
21. Gerber GS, Stockton BR. Trends in Endourologic Practice: Update on Laparoscopic Nephrectomy and Nephrourete- rectomy. J Endourol 2005; 19: 1151-3.
22. Kural AR, Demirkesen O, Akpinar H, Tufek I, Yalcin V, Ozkan B. Laparoskopik nefrektomide başlangıç deneyim- lerimiz. Türk Üroloji Dergisi 2004; 30: 414-21.
23. Philips J, Catto JW, Lavin V, et al. The laparoscpic nephrec- tomy learning curve: a single centre’s development of a de novo practise. Postgrad Med J 2005; 81: 599-603.
24. Rosales Bordes A, Salvador Bayarri J, Rodríguez O, Peña JA, Gaya JM, Parada Moreno R, et al. Limits of laparosco- pic surgery in the treatment of renal tumors. Actas Urol Esp 2009; 33: 550-61.
25. Steward GD, Ang WJ, Laird A, Tolley DA, Riddick AC, McNeill SA. The operative safety and oncological outco- mes of laparoscopic nephrectomy for T3 renal cell cancer. BJU Int 2012; 110: 884-90.
26. Siquera TM, Kuo RL, Gardner TA, et al. Major complicati- ons in 213 laparoscopic nephrectomy cases: The Indiano- polis experience. J Urol 2002; 168: 1361.
27. Erdogru T, Yucel S, Frede T, Baykara M, Rassweiler J, Teber D. Laparoscopic radical prostatectomy: transfer vadality. Int J Urol 2010; 17: 476-82.