Comparison Of Hand-assisted And Standard Laparoscopic Radical Nephrecomy

Purpose:To explore the clinical value of hand-assisted laparoscopic radical nephrectomy and standard laparoscopic radical nephrectomy by the comparison of the clinical indicators of the both surgical techniques.Methods:96patients who underwent laparoscopic radical nephrectomy in Minimally Invasive Urology Center of Shandong Provincial Hospital from January2010to December2011were retrospectively analyzed.Hand-assisted laparoscopic radical nephrectomy were performed in58patients,and standard laparoscopic radical nephrectomy were performed in the other38patients. We compare the operation time, intraoperative blood loss,postoperative anal exhaust time, postoperative drainage, the drainage tube indwelling time, postoperative ambulation activity time,postoperative hospital stay, complications and short-term follow-up results between the two groups to explore the clinical value of the two surgical techniques.Results:Between the hand-assisted laparoscopic groupe and the standard laparoscopic group,there are not significant differences in patient’s age, gender, tumor size, tumor side, and postoperative anal exhaust time,postoperative drainage, drainage tube indwelling time, postoperative ambulation activity time, postoperative hospital stay and complications.But the hand-assisted laparoscopic groupe have obviously shorter operation time (65.3±20.9vs95.8±33.7min) and less intraoperative blood loss (48.9±39.8vs123.9±72.7min),compared with standard laparoscopic group.3-27months of follow-up of all cases,no local recurrence or distant metastasis were found in patients of both of the groups.Conclusions:Compared with the standard laparoscopic radical nephrectomy,hand-assisted laparoscopic group has the advantages of shorter operative time,less bleeding. As a useful and necessary complement of the standard laparoscopic technique,hand-assisted laparoscopic technique retain the merit of laparoscopic surgery with less trauma, less pain, quick recovery, and shorten operative time, reduce bleeding and the risk of damage surrounding organs, benefit the removal of the specimen.