Laparoscopic partial nephrectomy (LPN) is the standard of care for localized small renal cancer. The most critical step in this form of surgery is to localize the renal artery. In the present study, we describe a novel technique that uses the left lumbar vein (LV) to access the left renal artery during LPN.
This was a retrospective review of 130 cases of transperitoneal laparoscopic partial nephrectomies (TLPNs) performed on patients with renal cancer in our center between January 2018 and December 2021. Either the LV or non-lumbar vein (N-LV) technique was used to locate and manage the left renal artery. We recorded relevant clinical data from all patients, including patient characteristics, tumor data, and perioperative outcomes (artery mobilization time, operative time, estimated blood loss, and complications). Comparative analysis was then carried out between the cases using LV or N-LV vein techniques.
All TLPNs were successfully accomplished without conversion to open approaches. There were no complications involving the renal vessels during the entire study. The LV technique resulted in a significantly shorter time to mobilize the renal and significantly less estimated blood loss (p < 0.05). There was no significant difference between the two techniques with regard to perioperative complications.
The left LV represents an anatomical landmark for locating the left renal artery in TLPN. This approach has numerous advantages over the transperitoneal approach including facilitating access to the left renal artery and reducing the duration of surgery.
Frontiers in surgery. 2022 Sep 05*** epublish ***
Zhongshun Yao, Jiming Zhao, Bin Zheng, Zixiang Cong, Yiming Zhang, Jiaju Lv, Zhihong Niu, Fajuan Cheng, Wei He
Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China., Department of Urology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China., Department of Nephrology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.