Application Of Retroperitoneal Laparoscopic Partial Nephrectomy In Intermediate And High Complex Renal Tumor

Objective: To study the efficacy and safety of retroperitoneal laparoscopic partialnephrectomy in intermediate and high complexity renal tumor.Method: From December2005to December2013,49cases of intermediatecomplexity and7cases of high complexity renal tumors were retrospectivelyanalyzed. Mean age was53.20±14.51years old; mean BMI was24.57±3.50; meantumor size was4.02±1.27cm in diameter; mean R.E.N.A.L. score was8.29±1.04,with31cases on the anterior position and25cases on the posterior side.12cases ofthe tumors were near the renal hilum. All the56patients received retroperitoneallaparoscopic partial nephrectomy.Result:56cases were operated successfully without conversion to open surgery, andsevere perioperative complication was rare. The mean operation time was142.68±47.51min, and mean warm ischemia time (WIT) was28.54±6.40min, andmean blood loss was175.71±160.06ml; mean postoperative hospital stay was8.55±3.73days. Postoperative urinary leakage can be witnessed in one case, butsymptom disappeared after10days of indwelling catheterization. The only one severecomplication happened on a female patient who had terrible hematuria after3days ofthe operation and received nephrectomy to resect the remaining kidney. Othercomplication includes: perinephric haematoma in one case, postoperative fever in fivecases and lung infection in one case.Conclusion: Treatment of retroperitoneal laparoscopic partial nephrectomy inintermediate and high complexity renal tumor is safe and effective, but its long-term effect still need to study by large sample with long-term follow-up.