Laparoscopic Radical Nephrectomy for Renal Tumor: The Washington University Experience

No AccessJournal of UrologyClinical Urology: Original Article1 Apr 1996Laparoscopic Radical Nephrectomy for Renal Tumor: The Washington University Experience Elspeth M. McDougall, Ralph V. Clayman, and Osama M. Elashry Elspeth M. McDougallElspeth M. McDougall , Ralph V. ClaymanRalph V. Clayman , and Osama M. ElashryOsama M. Elashry View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)66207-4AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We report our experience with laparoscopic radical nephrectomy in 17 consecutive patients with renal tumors. Materials and Methods: The clinical data on 17 consecutive patients undergoing laparoscopic radical nephrectomy were reviewed. Of the patients 12 with stage pT1 or pT2 renal cell carcinoma 7 cm. in diameter or smaller undergoing laparoscopic radical nephrectomy were compared to 12 undergoing open radical nephrectomy for stage pT1 or pT2 renal cell carcinoma 6 cm. in diameter or smaller. Results: Among the 17 patients undergoing laparoscopic radical nephrectomy average operative time was 6.9 hours (range 4.5 to 9) and average estimated blood loss was 105 cc (range 50 to 600). Average weight of the surgical specimen was 402 gm. (range 190 to 1,100). In 12 of 16 patients in whom laparoscopic radical nephrectomy was completed the specimen was removed intact. The patients required an average of 24 mg. morphine sulfate equivalent (range 2 to 220) for postoperative pain. Average hospital stay was 4.5 days (range 3 to 11) and average interval to resume normal activities was 3.5 weeks (range 2 to 4). The 12 patients in the open and laparoscopic radical nephrectomy groups were similar with respect to age, American Society of Anesthesiologists score and interval of surgery. Laparoscopic radical nephrectomy required significantly more operative time than open radical nephrectomy (6.9 versus 2.2 hours, respectively). However, the laparoscopic radical nephrectomy group compared to the open radical nephrectomy group had significantly less postoperative pain (24 versus 40 mg. morphine sulfate equivalent required for postoperative analgesia), shorter interval to resuming oral intake (1 versus 3 days), more rapid discharge from the hospital (4.5 versus 8.4 days) and more rapid return to normal activities (3.5 versus 5.1 weeks). The laparoscopic nephrectomy group also fully recovered more rapidly than the open surgical group (5.8 versus 39 weeks). To date, during a 4-year period there was no retroperitoneal recurrence or seeding of a port site. 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Volume 155Issue 4April 1996Page: 1180-1185 Advertisement Copyright & Permissions© 1996 by American Urological Association, Inc.MetricsAuthor Information Elspeth M. McDougall More articles by this author Ralph V. Clayman More articles by this author Osama M. Elashry More articles by this author Expand All Advertisement PDF downloadLoading ...