To present our surgical approach and initial experience of laparoscopic partial nephrectomy (LPN) with sequential precise tumor-specific segmental renal artery clamping in patients with multiple ipsilateral renal tumors.
Six patients with multiple ipsilateral renal tumors having imperative indications for nephron-sparing surgery underwent LPN with sequential precise tumor-specific segmental renal artery clamping from May 2012 to September 2015. Patient demographics, perioperative variables, renal functions and postoperative outcomes were reviewed.
Overall 15 tumors in 6 patients underwent the sequential precise tumor-specific segmental renal artery clamping LPN without conversion to conventional main renal artery clamping, open surgery or radical nephrectomy. No severe complication occurred. Mean size of the tumors was 2.5cm (range 1.8-3.5). Mean tumor-related warm ischemia time was 17 min (range 13-22). The affected kidney functions minimally decreased at recent follow-up and restored three months later. No positive tumor margin or extrarenal invasion breakthrough renal capsule was observed after pathologic analysis. Over 12 months follow-up, no local recurrence and distant metastasis were discovered in these cases postoperatively.
LPN with sequential precise tumor-specific segmental renal artery clamping is a feasible approach for multiple ipsilateral renal tumors. It minimizes intraoperative warm ischemic injury and promotes encouraging postoperative function of the affected kidney.
Urology. 2017 Jul 21 [Epub ahead of print]
Mingyue Tan, Yongzhi Xu, Dongliang Xu, Juntao Jiang, Wei Zhao, Di Cui, Yuan Ruan, Shujie Xia
Department of Urology, Shanghai General Hospital, School of Medicine, Shanghai Jiao Tong University, 200080, P. R. China., Department of Urology, Shanghai General Hospital, School of Medicine, Shanghai Jiao Tong University, 200080, P. R. China. Electronic address: .