Efficacy Of Laparoscopic Partial Nephrectomy For Centrally Located Renal Tumors And Peripherally Renal Tumors

Objective:To compare the clinical dates of laparoscopic partial nephrectomy for centrally located renal tumors and peripherally renal tumors and learn the efficacy and safety of the surgeroy method.Methods:Analyze the clinical dates of 12 patients who underwent LPN for centrally located renal tumors (10 of them were operated through abdominal cavity and 2 of them were operated through retroperitoneum) and the clinical dates of 116 patients who underwent LPN for peripherally located renal tumors in our hospital during March of 2013 to July of 2014. The location, size and adjacent relationship of the tumors were cleared by imaging tests before the operation. Four of them were para-hilus and 6 of them were operated with the help of laparoscopic ultrasonography. And indicators such as operation time, blood loss, pathology, cutting edge, renal function, ultrasound, CT and so on were assessed.Results:Demograghic data was comparable between the two groups (P>0.05).All the operations for the 12 centrally located renal tumors were completed successfully. The operation time was (135±18.6) minutes, the renal artery occlusion time was (24.4±3.2) minutes, the blood loss was (95±12.5) ml. One of the patients got postoperative bleeding and went well after conservative treatment. All patients were confirmed T1aN0M0 and negative margins with postoperative pathology. With a follow-up of 8 months to 2 years, no patients developed cancer recurrence. All the operations for the 116 peripherally located renal tumors were completed successfully. The operation time was (122±16.3) minutes, the renal artery occlusion time was (21.2±2.6) minutes, the blood loss was (95±12.5) m1.99 of the patients were confirmed T1aNOMO and 17 of the patients were confirmed T1bNOM0, with one of them got a positive margin without cancer recurrence during the follow-up time. With a follow-up of 8 months to 2 years, one patient developed cancer recurrence.Conclusion:Laparoscopic partial nephrectomy for centrally located tumor is safe and effective, the short term effect is positive, The application of LUS in LPN for some complicated centrally located renal tumors with real-time image helps surgeons to determine the location of the tumor and the position relation between the tumor and the vessels and the collection system, also helps to reduce intra-operative hemorrhage, provide negative incisal margins and guarantee the safety of the operation.